BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite imp...BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.展开更多
Parkinson’s disease(PD)is the second most common neurodegenerative disorder.The progressive degeneration of dopamine(DA)producing neurons in the midbrain is the pathological hallmark,which leads to debilitating motor...Parkinson’s disease(PD)is the second most common neurodegenerative disorder.The progressive degeneration of dopamine(DA)producing neurons in the midbrain is the pathological hallmark,which leads to debilitating motor symptoms,including tremors,rigidity,and bradykinesia.Drug treatments,such as levodopa,provide symptomatic relief.However,they do not halt disease progression,and their effectiveness diminishes over time(reviewed in Poewe et al.,2017).展开更多
AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospecti...AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.展开更多
BACKGROUND Duodenal adenocarcinoma(DA),a rare gastrointestinal malignancy,lacks clear natural history and management strategies.This study aimed to investigate the long-term outcomes of patients with DA,focusing on lo...BACKGROUND Duodenal adenocarcinoma(DA),a rare gastrointestinal malignancy,lacks clear natural history and management strategies.This study aimed to investigate the long-term outcomes of patients with DA,focusing on long-term survival and the impact of tumor characteristics,surgery,and adjuvant therapy.AIM To bridge this knowledge gap,we conducted a hospital-based cohort study in our 15-year experience with DA aimed at investigating the long-term outcomes of the patients with DA,along with analyzing the impact of the tumor characteristics,operations and adjuvant therapy on survival outcomes.METHODS A retrospective analysis of 208 patients diagnosed with non-ampullary DA at a single institution between 2009 and 2023 was performed.This study used SPSS 26.0 software to make a comprehensive statistical analysis of demographic characteristics,clinical presentation,treatment modalities,and survival outcomes.The effectiveness of surgical resection and adjuvant therapy in 5-year oval survival(OS)and disease-free survival was evaluated using Kaplan-Meier survival curves,the Cox proportional hazards model,and statistical comparisons of survival distributions.RESULTS The median OS time for the cohort was 39 months,with 3-and 5-year OS rates of 51.2%and 43.6%,respectively.Radical resection was performed in 82.6%of cases,and was significantly associated with an improved 5-year OS,with a rate of 57.8%.Adjuvant therapy showed a survival benefit in the specific patient subsets,particularly in tumor stage Ⅱ or Ⅲ tumors,with an improved OS.Adjuvant therapy(hazard ratio=2.71,95%confidence interval:1.30-5.62,P=0.008),pancreatic invasion and advanced tumor stage were identified as significant predictors of OS in multivariate analyses.CONCLUSION Radical operation for DA is associated with a remarkable improvement in the 5-year OS.Importantly,postoperative adjuvant therapy can significantly prolong the OS time in patients with radical operation,especially in patients with stage III.It highlights the necessity for early diagnosis,tailored surgical approaches,and a nuanced understanding of the role of adjuvant therapy.展开更多
Objective To describe survival trends and global patterns of esophageal cancer(EC)using survival data from population-based cancer registries.Methods We systematically searched PubMed,EMBASE,Web of Science,SEER,and Si...Objective To describe survival trends and global patterns of esophageal cancer(EC)using survival data from population-based cancer registries.Methods We systematically searched PubMed,EMBASE,Web of Science,SEER,and SinoMed databases for articles published up to 31 December 2023.Eligible EC survival estimates were evaluated according to country or region,period,sex,age group,pathology,and disease stage.Results After 2010,Jordan exhibited the highest age-standardized 5-year relative survival rates(RSRs)/net survival rates(NSRs)at 41.1%between 2010 and 2014,while India had the lowest,at 4.1%.Survival rates generally improved with diagnostic age across most countries,with significant increases in South Korea and China,of 12.7%and 10.5%between 2000 and 2017,respectively.Survival was higher among women compared to men,ranging from 0.4%-10.9%.Survival rates for adenocarcinoma and squamous cell carcinoma were similar,differing by about 4%.In China,the highest age-standardized RSRs/NSRs was 33.4%between 2015 and 2017.Meanwhile,the lowest was 5.3%,in Qidong(Jiangsu province)between 1992-1996.Conclusion Global EC survival rates have improved significantly in recent decades,but substantial geographical,sex,and age disparities still exist.In Asia,squamous cell carcinoma demonstrated superior survival rates compared to adenocarcinoma,while the opposite trend was observed in Western countries.Future research should clarify the prognostic factors influencing EC survival and tailor prevention and screening strategies to the changing EC survival patterns.展开更多
BACKGROUND Systemic immune-inflammation index(SII)combined with serum lactoferrin(LF)level can provide a reference for predicting the postoperative survival and prognosis of older patients with colon cancer.AIM To eva...BACKGROUND Systemic immune-inflammation index(SII)combined with serum lactoferrin(LF)level can provide a reference for predicting the postoperative survival and prognosis of older patients with colon cancer.AIM To evaluate the predictive value of SII combined with serum LF for postoperative survival in older patients with colon cancer.METHODS This prospective study included 62 older patients[range,65-85 years;average age(72.46±6.02)years]with colon cancer who underwent radical surgery at our hospital between January 2023 and September 2024.Colon cancer was confirmed on postoperative pathology.All patients underwent peripheral blood,LF,and tumor marker tests and imaging examinations preoperatively.The ability to predict overall survival(OS)and disease-free survival(DFS)by dynamically monitoring the SII[platelet(PLT)count×neutrophil(NEU)count/lymphocyte(LYM)count]and LF levels in combination with postoperative follow-up data was assessed.SII,LF levels,and postoperative data were analyzed using receiver operating characteristic curves,univariate,and multivariate Cox regression analyses to assess OS and DFS.RESULTS All patients were followed up conventionally postoperatively.There were no significant differences in the patients’baseline data.From 3 months preoperatively until after surgery,the values of routine blood indices(NEUs,LYMs,and PLTs)and SII tended to decrease,but the difference was not statistically significant.The LF level gradually decreased,and there were significant differences at 1 week,1 month and 3 months postoperatively(P<0.05).Liver and kidney functions significantly increased 1 week postoperatively and gradually recovered(P<0.05).The C-reactive protein level significantly increased 1 week postoperatively,whereas the prealbumin level significantly decreased then recovered 3 months postoperatively(P<0.05).The levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)significantly increased 6 months postoperatively,suggesting an increased risk of recurrence(P<0.05).Both the OS and DFS showed significant changes over time.Preoperative SII and LF levels had significant predictive values for OS and DFS.In logistics regression analysis,a SII of 585 or greater and LF level less than 185 ng/mL(determined by maximizing the Youden index)correlated with postoperative survival(P<0.05).Further Cox regression analysis showed that the SII and LF,CA19-9,and CEA levels were independent predictors of postoperative OS(P<0.05),whereas the tumor,node,metastasis stage;LF level;and SII were independent predictors of DFS.CONCLUSION This preliminary analysis suggests that the SII and LF levels may predict the survival and prognosis of older patients with colon cancer postoperatively,when assessing the risk of postoperative recurrence and complications.These two categories of indicators have good prognostic evaluation potential in clinical practice and can provide strong support for the development of individualized treatment strategies.展开更多
BACKGROUND Colorectal cancer(CRC)frequently metastasizes to the lungs,and image-guided thermal ablation(IGTA)has emerged as a promising treatment for oligometastatic colorectal lung metastases(CRLM).However,high-quali...BACKGROUND Colorectal cancer(CRC)frequently metastasizes to the lungs,and image-guided thermal ablation(IGTA)has emerged as a promising treatment for oligometastatic colorectal lung metastases(CRLM).However,high-quality multicenter data remain limited,and the prognostic impact of site-specific extrapulmonary metastases is not well defined.AIM To assess IGTA efficacy in potentially curable oligometastatic CRLM and determine prognostic impacts of extrapulmonary metastatic patterns.METHODS This multicenter real-world study analyzed 336 CRLM patients treated with IGTA from 2014 to 2022.Inclusion criteria included pathologically or clinically confirmed oligometastatic CRC,tumor diameter<50 mm,fewer than 5 metastatic lesions,and≤2 organs involved.Kaplan-Meier and Cox regression methods assessed survival outcomes,including local tumor progression-free survival,progression-free survival(PFS),and overall survival(OS).RESULTS The 3-year cumulative local tumor progression rate was 14.0%.Median PFS and OS were 15.6 and 51 months,respectively,with 3-and 5-year OS rates of 59.5%and 41.0%.Poor survival outcomes were associated with a higher tumor burden(larger size and greater number),carcinoembryonic antigen>20 ng/mL,carbohydrate antigen 19-9>37 U/mL,and extrapulmonary metastases.Patients without extrapulmonary metastasis had 1-,3-,and 5-year PFS rates of 65.4%,31.0%,and 27.3%,respectively,which were longer than those of CRLM patients with liver metastasis[hazard ratio(HR)=1.449,P=0.019]and abdominal cavity metastasis(HR=1.864,P=0.010).The 1-,3-,and 5-year OS rates for patients without extrapulmonary metastasis were 96.4%,71.0%,and 53.0%,respectively,which were significantly longer than those for patients with bone metastasis(HR=4.538,P<0.001),abdominal cavity metastasis(HR=4.813,P<0.001),and pelvic cavity metastasis(HR=3.105,P<0.001).CONCLUSION Metastatic patterns significantly influence PFS and OS,emphasizing the need for careful patient selection.Notably,patients with liver-only extrapulmonary metastasis demonstrate comparatively favorable outcomes,suggesting a distinct biological behavior and better prognosis within this subgroup.展开更多
Stem cell-based brain repair is a promising emergent therapy for Parkinson's disease based on years of foundational research using human fetal donors as a cell source.Unlike current therapeutic options for patient...Stem cell-based brain repair is a promising emergent therapy for Parkinson's disease based on years of foundational research using human fetal donors as a cell source.Unlike current therapeutic options for patients,this approach has the potential to provide longterm stem cell–derived reconstruction and restoration of the dopaminergic input to denervated regions of the brain allowing for restoration of certain functions to patients.The ultimate clinical success of stem cell–derived brain repair will depend on both the safety and efficacy of the approach and the latter is dependent on the ability of the transplanted cells to survive and differentiate into functional dopaminergic neurons in the Parkinsonian brain.Because the pre-clinical literature suggests that there is considerable variability in survival and differentiation between studies,the aim of this systematic review was to assess these parameters in human stem cell-derived dopaminergic progenitor transplant studies in animal models of Parkinson's disease.A defined systematic search of the PubMed database was completed to identify relevant studies published up to March 2024.After screening,76 articles were included in the analysis from which 178 separate transplant studies were identified.From these,graft survival could be assessed in 52 studies and differentiation in 129 studies.Overall,we found that graft survival ranged from<1% to 500% of cells transplanted,with a median of 51%of transplanted cells surviving in the brain;while dopaminergic differentiation of the cells ranged from 0% to 46% of cells transplanted with a median of 3%.This systematic review suggests that there is considerable scope for improvement in the differentiation of stem cell-derived dopaminergic progenitors to maximize the therapeutic potential of this approach for patients.展开更多
Background:Hepatocellular carcinoma(HCC)is the most common cause of cancer-related death in Saudi Arabia.Our study aimed to investigate the patterns of HCC and the effect of TNM staging,Alfa-fetoprotein(AFP),and Child...Background:Hepatocellular carcinoma(HCC)is the most common cause of cancer-related death in Saudi Arabia.Our study aimed to investigate the patterns of HCC and the effect of TNM staging,Alfa-fetoprotein(AFP),and Child-Turcotte Pugh(CTP)on patients’overall survival(OS).Methods:A retrospective analysis was conducted on 43 HCC patients at a single oncology center in Saudi Arabia from 2015 to 2020.All patients had to fulfill one of the following criteria:(a)a liver lesion reported as definitive HCC on dynamic imaging and/or(b)a biopsy-confirmed diagnosis.Results:The mean patient age of all HCC cases was 66.8 with a male-to-female ratio of 3.3:1.All patients were stratified into two groups:viral HCC(n=22,51%)and non-viral HCC(n=21,49%).Among viral-HCC patients,55%were due to HBV and 45%due to HCV.Cirrhosis was diagnosed in 79%of cases.Age and sex did not significantly statistically differ in OS among viral and non-viral HCC patients(p-value>0.05).About 65%of patients had tumor size>5 cm during the diagnosis,with a significant statistical difference in OS(p-value=0.027).AFP was>400 ng/ml in 45%of the patients.There was a statistically significant difference in the OS in terms of AFP levels(p-value=0.021).A statistically significant difference was also observed between the CTP score and OS(p-value=0.02).CTP class B had the longest survival.BSC was the most common treatment provided to HCC patients followed by sorafenib therapy.There was a significant statistical difference in OS among viral and non-viral HCC patients(p-value=0.008).Conclusions:The most common predictors for OS were the underlying cause of HCC,AFP,and tumor size.Being having non-viral etiology,a tumor size>5 cm,an AFP>400 ng/mL,and a CTP score class C were all negatively associated with OS.展开更多
BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patie...BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patients promises to greatly advance the customization of treatment approaches.AIM To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.METHODS This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1,2018,and December 12,2020.Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model.Its efficacy was assessed by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Nine variables were determined to be significant predictors of OS in EC patients:Body mass index(BMI),Karnofsky performance status,TNM stage,surgery,radiotherapy,chemotherapy,immunotherapy,platelet-to-lymphocyte ratio,and albumin-to-globulin ratio(ALB/GLB).The model demonstrated a C-index of 0.715(95%CI:0.701-0.729)in the training cohort and 0.711(95%CI:0.689-0.732)in the validation cohort.In the training cohort,AUCs for 1-year,3-year,and 5-year OS predictions were 0.773,0.787,and 0.750,respectively;in the validation cohort,they were 0.772,0.768,and 0.723,respectively,illustrating the model's precision.Calibration curves and DCA verified the model's predictive accuracy and net benefit.CONCLUSION A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.展开更多
BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram ...BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.展开更多
BACKGROUND Renal cell carcinoma(RCC)is treated with surgical resection as the gold standard,as it is notoriously resistant to systemic therapy.Advancements with targeted therapies contribute to declining mortality,but...BACKGROUND Renal cell carcinoma(RCC)is treated with surgical resection as the gold standard,as it is notoriously resistant to systemic therapy.Advancements with targeted therapies contribute to declining mortality,but metastatic RCC(mRCC)survival remains poor.One possible factor is treatment at academic centers,which employ advanced providers and novel therapies.This study compared outcomes of mRCC in patients treated at academic/research facilities compared to those treated at non-academic centers.AIM To compare survival outcomes of mRCC and their various etiologies between academic and non-academic centers.METHODS The National Cancer Database was used to identify mRCC patients including all histology subtypes and stage IV disease.Descriptive statistics and Kaplan-Meier curves measured survival outcomes for user file facility types sorted into a binary academic/research and non-academic research variable.Multivariate logistic regression and Cox proportional hazard testing generated odds ratio and hazard ratio.Data was analyzed using Statistical Package for the Social Sciences version 29.0 using a significance level of P<0.05.RESULTS Overall,academic facility patients experienced greater 5-year and 10-year overall survival than non-academic facility patients.Treatment at non-academic facilities was associated with increased odds of death that persisted even after controlling for age,tumor size,sex,and distance traveled to treatment center.In comparison,nonacademic facility patients also experienced greater risk of hazard.CONCLUSION Patients with mRCC treated at academic/research facilities experienced increased survival compared to patients treated at non-academic facilities,were more likely to be younger,carry private insurance,and come from a large metropolitan area.They also were significantly more likely to receive surgery and adjuvant immunotherapy.展开更多
BACKGROUND Advanced gastric cancer is characterized by fast tumor growth and aggressive biological behavior.During neoadjuvant chemotherapy,patients are at risk of distant metastasis or local progression.Anemia is a f...BACKGROUND Advanced gastric cancer is characterized by fast tumor growth and aggressive biological behavior.During neoadjuvant chemotherapy,patients are at risk of distant metastasis or local progression.Anemia is a frequent complication in these patients.AIM To analyze whether changes in hemoglobin and hematocrit can predict the survival and efficacy of neoadjuvant chemotherapy in patients with advanced gastric cancer.METHODS The clinical data of 185 patients with advanced gastric cancer admitted to the Third Affiliated Hospital of Chengdu Medical College,Pidu District People’s Hospital,Chengdu,China,between January 2016 and January 2021,were retrospectively analyzed.All patients underwent a tegafur+oxaliplatin+apatinib chemotherapy regimen.According to the efficacy of chemotherapy,they were divided into an effective group(complete or partial response,n=121)and an ineffective group(stable disease or disease progression,n=64).The factors related to chemotherapy efficacy in patients with advanced gastric cancer were analyzed by univariate and logistic multivariate analyses.The 3-year survival rates of the patients with different hemoglobin and hematocrit levels were compared.RESULTS Univariate analysis showed that the proportion of patients with a tumor diameter>5 cm,non-tubular adenocarcinoma,lymph node metastasis,hematocrit<33%,low mean red blood cell(RBC)protein content,low RBC distribution width,hemoglobin<107 g/L,and platelets>266×109/L in the ineffective group were significantly higher than those in the effective group(P<0.05).Logistic multivariate analysis showed that a tumor diameter>5 cm,lymph node metastasis,≤3 chemotherapy cycles,hematocrit<33%,and hemoglobin<107 g/L are risk factors for neoadjuvant chemotherapy failure in advanced gastric cancer(P<0.05).The 1-year,2-year,and 3-year survival rates in the effective group were 93.39%,83.47%,and 60.33%,respectively.These rates were significantly higher than those in the ineffective group(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hematocrit<33%were 74.67%,49.33%,and 29.33%,respectively,which were significantly lower than those of patients with hematocrit≥33%(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hemoglobin<107 g/L were 80.39%,58.82%,and 39.22%,respectively,which were significantly lower than those of patients with hemoglobin≥107 g/L(P<0.05).CONCLUSION Hematocrit<33%and hemoglobin<107 g/L are risk factors for chemotherapy failure in patients with advanced gastric cancer.They are associated with poorer prognosis and reduced 3-year survival rates.展开更多
BACKGROUND Bile spillage occurs more frequently in patients with incidental gallbladder carcinoma(iGBC)and may be associated with poor survival due to presumed high risk of peritoneal seeding.AIM To investigate the im...BACKGROUND Bile spillage occurs more frequently in patients with incidental gallbladder carcinoma(iGBC)and may be associated with poor survival due to presumed high risk of peritoneal seeding.AIM To investigate the impact of bile spillage during primary surgery on the survival of patients with iGBC.METHODS Medical records of patients with iGBC diagnosed between 2000 and 2019 in 27 Dutch secondary centers and 5 tertiary centers were retrospectively reviewed.Patient medical records were assessed.Predictors for overall survival(OS)were determined using multivariable Cox regression.RESULTS Of the 346 included patients with iGBC,138(39.9%)had bile spillage,which was associated with higher American Society of Anesthesiologists classification(P=0.020),cholecystitis(P<0.001),higher tumor stage(P=0.005),and non-radical resection(P<0.001).Bile spillage was associated with poor OS[hazard ratio=1.97,95%confidence interval(CI):1.48-2.63,P<0.001]with a median OS of 12 months(95%CI:7-18 months)vs 34 months(95%CI:14-55 months,P<0.001).In multivariable analysis,spillage was not an independent prognostic factor for survival(hazard ratio=1.21,95%CI:0.84-1.74,P=0.313).CONCLUSION Although bile spillage correlates with prognostic factors,it lacks independent prognostic significance for survival.Patients with an indication for additional treatment should be promptly referred to a specialized hepatopancreatobiliary center,irrespective of whether bile spillage has occurred.展开更多
There are various histological characteristics which have been proposed to predict the survival rate in colon cancer.However,there is no definitive model to accurately predict the survival.Therefore,it is important to...There are various histological characteristics which have been proposed to predict the survival rate in colon cancer.However,there is no definitive model to accurately predict the survival.Therefore,it is important to find out one model for the prediction of survival in colon cancer which may also include the preoperative,and operative factors in addition to histopathology.展开更多
BACKGROUND The hepatosplenic schistosomiasis(HSS)with portal hypertension can cause vascular complications such as hepatopulmonary syndrome(HPS).HPS increases the risk of mortality in patients with cirrhosis;however,t...BACKGROUND The hepatosplenic schistosomiasis(HSS)with portal hypertension can cause vascular complications such as hepatopulmonary syndrome(HPS).HPS increases the risk of mortality in patients with cirrhosis;however,there is no data on the mortality of patients with HSS and HPS.AIM To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic(schistosomiasis)portal hypertension.METHODS From August 2023 to January 2024,medical records and the official mortality information service of 121 patients who participated in a cross-sectional study on HPS between 2010 and 2012 were analyzed.Survival curves were created using the Kaplan-Meier method,and comparisons were performed using the log-rank test.Cox regression models estimated the hazard ratios(HR).RESULTS Overall,data of 113 patients were analyzed;most(55.8%)had HSS and concomitant cirrhosis(HSS/cirrhosis).Meanwhile,HPS was present in 39(34.5%)patients.Death occurred in 65 patients[57.5%];95%confidence interval(CI):48%-67%.The average time to death was lower in those with HPS when compared to those without HPS(3.37 years vs 5.65 years;P=0.017).According to the cause of liver disease,patients with HSS/cirrhosis died earlier,and their risk of death was twice as high compared with patients with HSS without cirrhosis(HR:2.17;95%CI:1.3-3.60;P=0.003).Meanwhile,there were no differences when comparing the two groups with and without HPS(HR:1.01;95%CI:0.59-1.73;P=0.967).CONCLUSION Patients with HSS and concomitant cirrhosis had a lower survival rate,but there was no difference in survival regardless of the presence of HPS.展开更多
Crassostrea gigas is distinguished by its robust fertility,adaptability to various environmental conditions,and rich nutritional profile,which render it a cornerstone of the global shellfish market.Tetraploid oysters,...Crassostrea gigas is distinguished by its robust fertility,adaptability to various environmental conditions,and rich nutritional profile,which render it a cornerstone of the global shellfish market.Tetraploid oysters,in particular,is a pivotal role within the oyster industry,however,their growth and survival characteristics need to be improved.This study aimed to assess the viability of enhancing the growth and survival characteristics of tetraploid C.gigas through genetic selection.This was achieved by investigating the heritability and genetic correlation of growth and survival at various stages of C.gigas development.Genetic parameters were assessed based on in-group correlations in 28 full-sib families during the larval stage(days 3,8,13,18,and 23 after fertilization).The heritability of larval shell height and shell length ranged from 0.50 to 0.71 and 0.44 to 0.71,respectively,and varied with age.The heritability of larval survival was 0.40–0.64,indicating that it is viable to enhancelarval survival through selection.The genetic correlation between the growth traits of larvae at different ages was highly positive(0.959–0.999),indicating that the selection of a single growth trait could cause the positive response of other growth traits.However,the genetic correlation between larval survival and growth traits was low,showing a significant negative correlation(-0.198–-0.293)at day 23 of age,suggesting thatselecting for enhanced survival in tetraploid C.gigas may result in a detrimental impact on growth traits.The results are helpful for future researches to evaluate the genetic parameters related to growth and survival traits in juvenile and adult stages of the tetraploid family of C.gigas,which can provide further guidance for the selection of tetraploid C.gigas.展开更多
BACKGROUND Treatment of metastatic gastric cancer(mGC)relies primarily on chemotherapy,which can be effectively combined with immunotherapy.Despite these interventions,overall survival remains suboptimal.CASE SUMMARY ...BACKGROUND Treatment of metastatic gastric cancer(mGC)relies primarily on chemotherapy,which can be effectively combined with immunotherapy.Despite these interventions,overall survival remains suboptimal.CASE SUMMARY We report a patient with mGC who received S-1 plus oxaliplatin with sintilimab as first-line therapy,followed by maintenance therapy with S-1 and sintilimab.After 6 months,a partial response was observed,with a 71.7%reduction in the target lesion.After 13 months,the reduction reached 76.3%.Treatment was temporarily paused for 6 months due to a pulmonary infection.Upon re-evaluation 6 months later,the tumor continued to regress,with a 79.4%reduction in the target lesion.The original regimen was then resumed.From diagnosis to date,progression-free survival has reached 23 months.CONCLUSION Sintilimab combined with chemotherapy demonstrated improved progressionfree survival and warrants further investigation in mGC.展开更多
BACKGROUND The prevalence and mortality rates of gastric carcinoma are disproportionately elevated in China,with the disease's intricate and varied characteristics further amplifying its health impact.Precise fore...BACKGROUND The prevalence and mortality rates of gastric carcinoma are disproportionately elevated in China,with the disease's intricate and varied characteristics further amplifying its health impact.Precise forecasting of overall survival(OS)is of paramount importance for the clinical management of individuals afflicted with this malignancy.AIM To develop and validate a nomogram model that provides precise gastric cancer prevention and treatment guidance and more accurate survival outcome prediction for patients with gastric carcinoma.METHODS Data analysis was conducted on samples collected from hospitalized gastric cancer patients between 2018 and 2020.Least absolute shrinkage and selection operator,univariate,and multivariate Cox regression analyses were employed to identify independent prognostic factors.A nomogram model was developed to predict gastric cancer patient outcomes.The model's predictability and discriminative ability were evaluated via receiver operating characteristic curves.To evaluate the clinical utility of the model,Kaplan-Meier and decision curve analyses were performed.RESULTS A total of ten independent prognostic factors were identified,including body mass index,tumor-node-metastasis(TNM)stage,radiation,chemotherapy,surgery,albumin,globulin,neutrophil count,lactate dehydrogenase,and platelet-to-lymphocyte ratio.The area under the curve(AUC)values for the 1-,3-,and 5-year survival prediction in the training set were 0.843,0.850,and 0.821,respectively.The AUC values were 0.864,0.820,and 0.786 for the 1-,3-,and 5-year survival prediction in the validation set,respectively.The model exhibited strong discriminative ability,with both the time AUC and time C-index exceeding 0.75.Compared with TNM staging,the model demonstrated superior clinical utility.Ultimately,a nomogram was developed via a web-based interface.CONCLUSION This study established and validated a novel nomogram model for predicting the OS of gastric cancer patients,which demonstrated strong predictive ability.Based on these findings,this model can aid clinicians in implementing personalized interventions for patients with gastric cancer.展开更多
BACKGROUND Heart transplantation is the last and best option for end-stage heart failure management.Early mortality rates have significantly decreased,enabling patients to survive longer with fewer complications,a tre...BACKGROUND Heart transplantation is the last and best option for end-stage heart failure management.Early mortality rates have significantly decreased,enabling patients to survive longer with fewer complications,a trend observed even in our setting.The primary shared challenge has centered on achieving surgical success and immediate survival.The question arises about the medium-and long-term survival of patients with heart transplant in Mexico.AIM To present the results of the medium and long-term follow-up of heart transplant patients.METHODS This was a retrospective study of a single medical unit,and we selected patients who received heart transplants from July 21,1988 to September 30,2023.Selection criteria encompassed age,sex,and primary indication for heart transplantation across all groups.Patients with incomplete information or who died within 30 postoperative days were excluded.Data of primary pathology,ischemic,extracorporeal circulation,aortic cross-clamping times,length of ventilatory support,stay in postoperative therapy,hospitalization,and functional class were analyzed.RESULTS The causes of morbidity,mortality,and percentage of survival at 1,5,and 10 years were examined.Overall,257 heart transplants were performed during the study period.Of the total cases,22 with incomplete data and 47 who died within 30 postoperative days were excluded for the middle-and long-term survival analyses.Of the remaining 188 patients,heart transplantation was performed(males:146,females:42).The average age of the participants was 44.43±14.48 years.The primary indications included ischemic cardiomyopathy(42.55%)and dilated cardiomyopathy(39.36%).The mean durations of mechanical ventilator support,intensive care stay,and hospital stay were 57.55±103.50 hours,9.96±8.59 days,and 19.49±18.23 days,respectively.One-,five-,and ten-year survival rates were 90.7%,71.3%,and 60.3%,respectively.Of the patients,94%and 6%were in functional classes I and II,respectively.Infection and neurological hemorrhagic or ischemic stroke(26%)were the main causes of mortality in the first year.Subsequently,chronic rejection manifesting as graft vasculopathy increased in frequency(30%).CONCLUSION In our setting,heart transplantation yields medium-and long-term survival and quality of life outcomes comparable to those achieved by other international centers.展开更多
文摘BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.
基金supported by the DGIST start-up funds from the Ministry of Science and ICT(2024010330)a National Research Foundation of Korea(NRF)grant funded by the Korea Government(MSIT)(No.RS-2024-00351442)(to TWK).
文摘Parkinson’s disease(PD)is the second most common neurodegenerative disorder.The progressive degeneration of dopamine(DA)producing neurons in the midbrain is the pathological hallmark,which leads to debilitating motor symptoms,including tremors,rigidity,and bradykinesia.Drug treatments,such as levodopa,provide symptomatic relief.However,they do not halt disease progression,and their effectiveness diminishes over time(reviewed in Poewe et al.,2017).
基金Supported by the Faculty of Medicine,Prince of Songkla University.Wainipitapong S has received grants from the Faculty of Medicine,Prince of Songkla University。
文摘AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.
基金Supported by Natural Science Foundation of Guangdong Province of China,No.2023A1515010785Key Clinical Technique of Guangzhou,No.2023P-ZD01Clinical Research Program of Nanfang Hospital,Southern Medical University,No.2021CR003.
文摘BACKGROUND Duodenal adenocarcinoma(DA),a rare gastrointestinal malignancy,lacks clear natural history and management strategies.This study aimed to investigate the long-term outcomes of patients with DA,focusing on long-term survival and the impact of tumor characteristics,surgery,and adjuvant therapy.AIM To bridge this knowledge gap,we conducted a hospital-based cohort study in our 15-year experience with DA aimed at investigating the long-term outcomes of the patients with DA,along with analyzing the impact of the tumor characteristics,operations and adjuvant therapy on survival outcomes.METHODS A retrospective analysis of 208 patients diagnosed with non-ampullary DA at a single institution between 2009 and 2023 was performed.This study used SPSS 26.0 software to make a comprehensive statistical analysis of demographic characteristics,clinical presentation,treatment modalities,and survival outcomes.The effectiveness of surgical resection and adjuvant therapy in 5-year oval survival(OS)and disease-free survival was evaluated using Kaplan-Meier survival curves,the Cox proportional hazards model,and statistical comparisons of survival distributions.RESULTS The median OS time for the cohort was 39 months,with 3-and 5-year OS rates of 51.2%and 43.6%,respectively.Radical resection was performed in 82.6%of cases,and was significantly associated with an improved 5-year OS,with a rate of 57.8%.Adjuvant therapy showed a survival benefit in the specific patient subsets,particularly in tumor stage Ⅱ or Ⅲ tumors,with an improved OS.Adjuvant therapy(hazard ratio=2.71,95%confidence interval:1.30-5.62,P=0.008),pancreatic invasion and advanced tumor stage were identified as significant predictors of OS in multivariate analyses.CONCLUSION Radical operation for DA is associated with a remarkable improvement in the 5-year OS.Importantly,postoperative adjuvant therapy can significantly prolong the OS time in patients with radical operation,especially in patients with stage III.It highlights the necessity for early diagnosis,tailored surgical approaches,and a nuanced understanding of the role of adjuvant therapy.
基金supported by the National Key Project of Research and Development Program of China[2021YFC2500404,2021YFC2500405].
文摘Objective To describe survival trends and global patterns of esophageal cancer(EC)using survival data from population-based cancer registries.Methods We systematically searched PubMed,EMBASE,Web of Science,SEER,and SinoMed databases for articles published up to 31 December 2023.Eligible EC survival estimates were evaluated according to country or region,period,sex,age group,pathology,and disease stage.Results After 2010,Jordan exhibited the highest age-standardized 5-year relative survival rates(RSRs)/net survival rates(NSRs)at 41.1%between 2010 and 2014,while India had the lowest,at 4.1%.Survival rates generally improved with diagnostic age across most countries,with significant increases in South Korea and China,of 12.7%and 10.5%between 2000 and 2017,respectively.Survival was higher among women compared to men,ranging from 0.4%-10.9%.Survival rates for adenocarcinoma and squamous cell carcinoma were similar,differing by about 4%.In China,the highest age-standardized RSRs/NSRs was 33.4%between 2015 and 2017.Meanwhile,the lowest was 5.3%,in Qidong(Jiangsu province)between 1992-1996.Conclusion Global EC survival rates have improved significantly in recent decades,but substantial geographical,sex,and age disparities still exist.In Asia,squamous cell carcinoma demonstrated superior survival rates compared to adenocarcinoma,while the opposite trend was observed in Western countries.Future research should clarify the prognostic factors influencing EC survival and tailor prevention and screening strategies to the changing EC survival patterns.
基金Supported by Rugao Science and Technology Research and Development Program(Agriculture and Social Development)Project,No.SRGS(24)061.
文摘BACKGROUND Systemic immune-inflammation index(SII)combined with serum lactoferrin(LF)level can provide a reference for predicting the postoperative survival and prognosis of older patients with colon cancer.AIM To evaluate the predictive value of SII combined with serum LF for postoperative survival in older patients with colon cancer.METHODS This prospective study included 62 older patients[range,65-85 years;average age(72.46±6.02)years]with colon cancer who underwent radical surgery at our hospital between January 2023 and September 2024.Colon cancer was confirmed on postoperative pathology.All patients underwent peripheral blood,LF,and tumor marker tests and imaging examinations preoperatively.The ability to predict overall survival(OS)and disease-free survival(DFS)by dynamically monitoring the SII[platelet(PLT)count×neutrophil(NEU)count/lymphocyte(LYM)count]and LF levels in combination with postoperative follow-up data was assessed.SII,LF levels,and postoperative data were analyzed using receiver operating characteristic curves,univariate,and multivariate Cox regression analyses to assess OS and DFS.RESULTS All patients were followed up conventionally postoperatively.There were no significant differences in the patients’baseline data.From 3 months preoperatively until after surgery,the values of routine blood indices(NEUs,LYMs,and PLTs)and SII tended to decrease,but the difference was not statistically significant.The LF level gradually decreased,and there were significant differences at 1 week,1 month and 3 months postoperatively(P<0.05).Liver and kidney functions significantly increased 1 week postoperatively and gradually recovered(P<0.05).The C-reactive protein level significantly increased 1 week postoperatively,whereas the prealbumin level significantly decreased then recovered 3 months postoperatively(P<0.05).The levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)significantly increased 6 months postoperatively,suggesting an increased risk of recurrence(P<0.05).Both the OS and DFS showed significant changes over time.Preoperative SII and LF levels had significant predictive values for OS and DFS.In logistics regression analysis,a SII of 585 or greater and LF level less than 185 ng/mL(determined by maximizing the Youden index)correlated with postoperative survival(P<0.05).Further Cox regression analysis showed that the SII and LF,CA19-9,and CEA levels were independent predictors of postoperative OS(P<0.05),whereas the tumor,node,metastasis stage;LF level;and SII were independent predictors of DFS.CONCLUSION This preliminary analysis suggests that the SII and LF levels may predict the survival and prognosis of older patients with colon cancer postoperatively,when assessing the risk of postoperative recurrence and complications.These two categories of indicators have good prognostic evaluation potential in clinical practice and can provide strong support for the development of individualized treatment strategies.
基金Supported by the National Natural Science Foundation of China,No.82302332 and No.82272100Guiding Science and Technology Research Project of Quzhou,No.ZD2022020.
文摘BACKGROUND Colorectal cancer(CRC)frequently metastasizes to the lungs,and image-guided thermal ablation(IGTA)has emerged as a promising treatment for oligometastatic colorectal lung metastases(CRLM).However,high-quality multicenter data remain limited,and the prognostic impact of site-specific extrapulmonary metastases is not well defined.AIM To assess IGTA efficacy in potentially curable oligometastatic CRLM and determine prognostic impacts of extrapulmonary metastatic patterns.METHODS This multicenter real-world study analyzed 336 CRLM patients treated with IGTA from 2014 to 2022.Inclusion criteria included pathologically or clinically confirmed oligometastatic CRC,tumor diameter<50 mm,fewer than 5 metastatic lesions,and≤2 organs involved.Kaplan-Meier and Cox regression methods assessed survival outcomes,including local tumor progression-free survival,progression-free survival(PFS),and overall survival(OS).RESULTS The 3-year cumulative local tumor progression rate was 14.0%.Median PFS and OS were 15.6 and 51 months,respectively,with 3-and 5-year OS rates of 59.5%and 41.0%.Poor survival outcomes were associated with a higher tumor burden(larger size and greater number),carcinoembryonic antigen>20 ng/mL,carbohydrate antigen 19-9>37 U/mL,and extrapulmonary metastases.Patients without extrapulmonary metastasis had 1-,3-,and 5-year PFS rates of 65.4%,31.0%,and 27.3%,respectively,which were longer than those of CRLM patients with liver metastasis[hazard ratio(HR)=1.449,P=0.019]and abdominal cavity metastasis(HR=1.864,P=0.010).The 1-,3-,and 5-year OS rates for patients without extrapulmonary metastasis were 96.4%,71.0%,and 53.0%,respectively,which were significantly longer than those for patients with bone metastasis(HR=4.538,P<0.001),abdominal cavity metastasis(HR=4.813,P<0.001),and pelvic cavity metastasis(HR=3.105,P<0.001).CONCLUSION Metastatic patterns significantly influence PFS and OS,emphasizing the need for careful patient selection.Notably,patients with liver-only extrapulmonary metastasis demonstrate comparatively favorable outcomes,suggesting a distinct biological behavior and better prognosis within this subgroup.
基金supported by research grants from the Michael J Fox Foundation for Parkinson’s Research(grant numbers:17244 and 023410)Science Foundation Ireland(Grant Numbers:19/FFP/6554)(to ED)。
文摘Stem cell-based brain repair is a promising emergent therapy for Parkinson's disease based on years of foundational research using human fetal donors as a cell source.Unlike current therapeutic options for patients,this approach has the potential to provide longterm stem cell–derived reconstruction and restoration of the dopaminergic input to denervated regions of the brain allowing for restoration of certain functions to patients.The ultimate clinical success of stem cell–derived brain repair will depend on both the safety and efficacy of the approach and the latter is dependent on the ability of the transplanted cells to survive and differentiate into functional dopaminergic neurons in the Parkinsonian brain.Because the pre-clinical literature suggests that there is considerable variability in survival and differentiation between studies,the aim of this systematic review was to assess these parameters in human stem cell-derived dopaminergic progenitor transplant studies in animal models of Parkinson's disease.A defined systematic search of the PubMed database was completed to identify relevant studies published up to March 2024.After screening,76 articles were included in the analysis from which 178 separate transplant studies were identified.From these,graft survival could be assessed in 52 studies and differentiation in 129 studies.Overall,we found that graft survival ranged from<1% to 500% of cells transplanted,with a median of 51%of transplanted cells surviving in the brain;while dopaminergic differentiation of the cells ranged from 0% to 46% of cells transplanted with a median of 3%.This systematic review suggests that there is considerable scope for improvement in the differentiation of stem cell-derived dopaminergic progenitors to maximize the therapeutic potential of this approach for patients.
文摘Background:Hepatocellular carcinoma(HCC)is the most common cause of cancer-related death in Saudi Arabia.Our study aimed to investigate the patterns of HCC and the effect of TNM staging,Alfa-fetoprotein(AFP),and Child-Turcotte Pugh(CTP)on patients’overall survival(OS).Methods:A retrospective analysis was conducted on 43 HCC patients at a single oncology center in Saudi Arabia from 2015 to 2020.All patients had to fulfill one of the following criteria:(a)a liver lesion reported as definitive HCC on dynamic imaging and/or(b)a biopsy-confirmed diagnosis.Results:The mean patient age of all HCC cases was 66.8 with a male-to-female ratio of 3.3:1.All patients were stratified into two groups:viral HCC(n=22,51%)and non-viral HCC(n=21,49%).Among viral-HCC patients,55%were due to HBV and 45%due to HCV.Cirrhosis was diagnosed in 79%of cases.Age and sex did not significantly statistically differ in OS among viral and non-viral HCC patients(p-value>0.05).About 65%of patients had tumor size>5 cm during the diagnosis,with a significant statistical difference in OS(p-value=0.027).AFP was>400 ng/ml in 45%of the patients.There was a statistically significant difference in the OS in terms of AFP levels(p-value=0.021).A statistically significant difference was also observed between the CTP score and OS(p-value=0.02).CTP class B had the longest survival.BSC was the most common treatment provided to HCC patients followed by sorafenib therapy.There was a significant statistical difference in OS among viral and non-viral HCC patients(p-value=0.008).Conclusions:The most common predictors for OS were the underlying cause of HCC,AFP,and tumor size.Being having non-viral etiology,a tumor size>5 cm,an AFP>400 ng/mL,and a CTP score class C were all negatively associated with OS.
文摘BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patients promises to greatly advance the customization of treatment approaches.AIM To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.METHODS This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1,2018,and December 12,2020.Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model.Its efficacy was assessed by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Nine variables were determined to be significant predictors of OS in EC patients:Body mass index(BMI),Karnofsky performance status,TNM stage,surgery,radiotherapy,chemotherapy,immunotherapy,platelet-to-lymphocyte ratio,and albumin-to-globulin ratio(ALB/GLB).The model demonstrated a C-index of 0.715(95%CI:0.701-0.729)in the training cohort and 0.711(95%CI:0.689-0.732)in the validation cohort.In the training cohort,AUCs for 1-year,3-year,and 5-year OS predictions were 0.773,0.787,and 0.750,respectively;in the validation cohort,they were 0.772,0.768,and 0.723,respectively,illustrating the model's precision.Calibration curves and DCA verified the model's predictive accuracy and net benefit.CONCLUSION A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.
基金Supported by the Appropriate Technology Promotion Program in Chongqing,No.2023jstg005.
文摘BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.
文摘BACKGROUND Renal cell carcinoma(RCC)is treated with surgical resection as the gold standard,as it is notoriously resistant to systemic therapy.Advancements with targeted therapies contribute to declining mortality,but metastatic RCC(mRCC)survival remains poor.One possible factor is treatment at academic centers,which employ advanced providers and novel therapies.This study compared outcomes of mRCC in patients treated at academic/research facilities compared to those treated at non-academic centers.AIM To compare survival outcomes of mRCC and their various etiologies between academic and non-academic centers.METHODS The National Cancer Database was used to identify mRCC patients including all histology subtypes and stage IV disease.Descriptive statistics and Kaplan-Meier curves measured survival outcomes for user file facility types sorted into a binary academic/research and non-academic research variable.Multivariate logistic regression and Cox proportional hazard testing generated odds ratio and hazard ratio.Data was analyzed using Statistical Package for the Social Sciences version 29.0 using a significance level of P<0.05.RESULTS Overall,academic facility patients experienced greater 5-year and 10-year overall survival than non-academic facility patients.Treatment at non-academic facilities was associated with increased odds of death that persisted even after controlling for age,tumor size,sex,and distance traveled to treatment center.In comparison,nonacademic facility patients also experienced greater risk of hazard.CONCLUSION Patients with mRCC treated at academic/research facilities experienced increased survival compared to patients treated at non-academic facilities,were more likely to be younger,carry private insurance,and come from a large metropolitan area.They also were significantly more likely to receive surgery and adjuvant immunotherapy.
文摘BACKGROUND Advanced gastric cancer is characterized by fast tumor growth and aggressive biological behavior.During neoadjuvant chemotherapy,patients are at risk of distant metastasis or local progression.Anemia is a frequent complication in these patients.AIM To analyze whether changes in hemoglobin and hematocrit can predict the survival and efficacy of neoadjuvant chemotherapy in patients with advanced gastric cancer.METHODS The clinical data of 185 patients with advanced gastric cancer admitted to the Third Affiliated Hospital of Chengdu Medical College,Pidu District People’s Hospital,Chengdu,China,between January 2016 and January 2021,were retrospectively analyzed.All patients underwent a tegafur+oxaliplatin+apatinib chemotherapy regimen.According to the efficacy of chemotherapy,they were divided into an effective group(complete or partial response,n=121)and an ineffective group(stable disease or disease progression,n=64).The factors related to chemotherapy efficacy in patients with advanced gastric cancer were analyzed by univariate and logistic multivariate analyses.The 3-year survival rates of the patients with different hemoglobin and hematocrit levels were compared.RESULTS Univariate analysis showed that the proportion of patients with a tumor diameter>5 cm,non-tubular adenocarcinoma,lymph node metastasis,hematocrit<33%,low mean red blood cell(RBC)protein content,low RBC distribution width,hemoglobin<107 g/L,and platelets>266×109/L in the ineffective group were significantly higher than those in the effective group(P<0.05).Logistic multivariate analysis showed that a tumor diameter>5 cm,lymph node metastasis,≤3 chemotherapy cycles,hematocrit<33%,and hemoglobin<107 g/L are risk factors for neoadjuvant chemotherapy failure in advanced gastric cancer(P<0.05).The 1-year,2-year,and 3-year survival rates in the effective group were 93.39%,83.47%,and 60.33%,respectively.These rates were significantly higher than those in the ineffective group(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hematocrit<33%were 74.67%,49.33%,and 29.33%,respectively,which were significantly lower than those of patients with hematocrit≥33%(P<0.05).The 1-year,2-year,and 3-year survival rates of patients with hemoglobin<107 g/L were 80.39%,58.82%,and 39.22%,respectively,which were significantly lower than those of patients with hemoglobin≥107 g/L(P<0.05).CONCLUSION Hematocrit<33%and hemoglobin<107 g/L are risk factors for chemotherapy failure in patients with advanced gastric cancer.They are associated with poorer prognosis and reduced 3-year survival rates.
文摘BACKGROUND Bile spillage occurs more frequently in patients with incidental gallbladder carcinoma(iGBC)and may be associated with poor survival due to presumed high risk of peritoneal seeding.AIM To investigate the impact of bile spillage during primary surgery on the survival of patients with iGBC.METHODS Medical records of patients with iGBC diagnosed between 2000 and 2019 in 27 Dutch secondary centers and 5 tertiary centers were retrospectively reviewed.Patient medical records were assessed.Predictors for overall survival(OS)were determined using multivariable Cox regression.RESULTS Of the 346 included patients with iGBC,138(39.9%)had bile spillage,which was associated with higher American Society of Anesthesiologists classification(P=0.020),cholecystitis(P<0.001),higher tumor stage(P=0.005),and non-radical resection(P<0.001).Bile spillage was associated with poor OS[hazard ratio=1.97,95%confidence interval(CI):1.48-2.63,P<0.001]with a median OS of 12 months(95%CI:7-18 months)vs 34 months(95%CI:14-55 months,P<0.001).In multivariable analysis,spillage was not an independent prognostic factor for survival(hazard ratio=1.21,95%CI:0.84-1.74,P=0.313).CONCLUSION Although bile spillage correlates with prognostic factors,it lacks independent prognostic significance for survival.Patients with an indication for additional treatment should be promptly referred to a specialized hepatopancreatobiliary center,irrespective of whether bile spillage has occurred.
文摘There are various histological characteristics which have been proposed to predict the survival rate in colon cancer.However,there is no definitive model to accurately predict the survival.Therefore,it is important to find out one model for the prediction of survival in colon cancer which may also include the preoperative,and operative factors in addition to histopathology.
文摘BACKGROUND The hepatosplenic schistosomiasis(HSS)with portal hypertension can cause vascular complications such as hepatopulmonary syndrome(HPS).HPS increases the risk of mortality in patients with cirrhosis;however,there is no data on the mortality of patients with HSS and HPS.AIM To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic(schistosomiasis)portal hypertension.METHODS From August 2023 to January 2024,medical records and the official mortality information service of 121 patients who participated in a cross-sectional study on HPS between 2010 and 2012 were analyzed.Survival curves were created using the Kaplan-Meier method,and comparisons were performed using the log-rank test.Cox regression models estimated the hazard ratios(HR).RESULTS Overall,data of 113 patients were analyzed;most(55.8%)had HSS and concomitant cirrhosis(HSS/cirrhosis).Meanwhile,HPS was present in 39(34.5%)patients.Death occurred in 65 patients[57.5%];95%confidence interval(CI):48%-67%.The average time to death was lower in those with HPS when compared to those without HPS(3.37 years vs 5.65 years;P=0.017).According to the cause of liver disease,patients with HSS/cirrhosis died earlier,and their risk of death was twice as high compared with patients with HSS without cirrhosis(HR:2.17;95%CI:1.3-3.60;P=0.003).Meanwhile,there were no differences when comparing the two groups with and without HPS(HR:1.01;95%CI:0.59-1.73;P=0.967).CONCLUSION Patients with HSS and concomitant cirrhosis had a lower survival rate,but there was no difference in survival regardless of the presence of HPS.
基金supported by grants from the National Natural Science Foundation of China(No.32373115)the Earmarked Fund for Agriculture Seed Improvement Project of Shandong Province(Nos.2022LZGCQY010,2021ZLGX03 and 2021TSGC1240)the China Agriculture Research System Project(No.CARS-49)。
文摘Crassostrea gigas is distinguished by its robust fertility,adaptability to various environmental conditions,and rich nutritional profile,which render it a cornerstone of the global shellfish market.Tetraploid oysters,in particular,is a pivotal role within the oyster industry,however,their growth and survival characteristics need to be improved.This study aimed to assess the viability of enhancing the growth and survival characteristics of tetraploid C.gigas through genetic selection.This was achieved by investigating the heritability and genetic correlation of growth and survival at various stages of C.gigas development.Genetic parameters were assessed based on in-group correlations in 28 full-sib families during the larval stage(days 3,8,13,18,and 23 after fertilization).The heritability of larval shell height and shell length ranged from 0.50 to 0.71 and 0.44 to 0.71,respectively,and varied with age.The heritability of larval survival was 0.40–0.64,indicating that it is viable to enhancelarval survival through selection.The genetic correlation between the growth traits of larvae at different ages was highly positive(0.959–0.999),indicating that the selection of a single growth trait could cause the positive response of other growth traits.However,the genetic correlation between larval survival and growth traits was low,showing a significant negative correlation(-0.198–-0.293)at day 23 of age,suggesting thatselecting for enhanced survival in tetraploid C.gigas may result in a detrimental impact on growth traits.The results are helpful for future researches to evaluate the genetic parameters related to growth and survival traits in juvenile and adult stages of the tetraploid family of C.gigas,which can provide further guidance for the selection of tetraploid C.gigas.
文摘BACKGROUND Treatment of metastatic gastric cancer(mGC)relies primarily on chemotherapy,which can be effectively combined with immunotherapy.Despite these interventions,overall survival remains suboptimal.CASE SUMMARY We report a patient with mGC who received S-1 plus oxaliplatin with sintilimab as first-line therapy,followed by maintenance therapy with S-1 and sintilimab.After 6 months,a partial response was observed,with a 71.7%reduction in the target lesion.After 13 months,the reduction reached 76.3%.Treatment was temporarily paused for 6 months due to a pulmonary infection.Upon re-evaluation 6 months later,the tumor continued to regress,with a 79.4%reduction in the target lesion.The original regimen was then resumed.From diagnosis to date,progression-free survival has reached 23 months.CONCLUSION Sintilimab combined with chemotherapy demonstrated improved progressionfree survival and warrants further investigation in mGC.
文摘BACKGROUND The prevalence and mortality rates of gastric carcinoma are disproportionately elevated in China,with the disease's intricate and varied characteristics further amplifying its health impact.Precise forecasting of overall survival(OS)is of paramount importance for the clinical management of individuals afflicted with this malignancy.AIM To develop and validate a nomogram model that provides precise gastric cancer prevention and treatment guidance and more accurate survival outcome prediction for patients with gastric carcinoma.METHODS Data analysis was conducted on samples collected from hospitalized gastric cancer patients between 2018 and 2020.Least absolute shrinkage and selection operator,univariate,and multivariate Cox regression analyses were employed to identify independent prognostic factors.A nomogram model was developed to predict gastric cancer patient outcomes.The model's predictability and discriminative ability were evaluated via receiver operating characteristic curves.To evaluate the clinical utility of the model,Kaplan-Meier and decision curve analyses were performed.RESULTS A total of ten independent prognostic factors were identified,including body mass index,tumor-node-metastasis(TNM)stage,radiation,chemotherapy,surgery,albumin,globulin,neutrophil count,lactate dehydrogenase,and platelet-to-lymphocyte ratio.The area under the curve(AUC)values for the 1-,3-,and 5-year survival prediction in the training set were 0.843,0.850,and 0.821,respectively.The AUC values were 0.864,0.820,and 0.786 for the 1-,3-,and 5-year survival prediction in the validation set,respectively.The model exhibited strong discriminative ability,with both the time AUC and time C-index exceeding 0.75.Compared with TNM staging,the model demonstrated superior clinical utility.Ultimately,a nomogram was developed via a web-based interface.CONCLUSION This study established and validated a novel nomogram model for predicting the OS of gastric cancer patients,which demonstrated strong predictive ability.Based on these findings,this model can aid clinicians in implementing personalized interventions for patients with gastric cancer.
文摘BACKGROUND Heart transplantation is the last and best option for end-stage heart failure management.Early mortality rates have significantly decreased,enabling patients to survive longer with fewer complications,a trend observed even in our setting.The primary shared challenge has centered on achieving surgical success and immediate survival.The question arises about the medium-and long-term survival of patients with heart transplant in Mexico.AIM To present the results of the medium and long-term follow-up of heart transplant patients.METHODS This was a retrospective study of a single medical unit,and we selected patients who received heart transplants from July 21,1988 to September 30,2023.Selection criteria encompassed age,sex,and primary indication for heart transplantation across all groups.Patients with incomplete information or who died within 30 postoperative days were excluded.Data of primary pathology,ischemic,extracorporeal circulation,aortic cross-clamping times,length of ventilatory support,stay in postoperative therapy,hospitalization,and functional class were analyzed.RESULTS The causes of morbidity,mortality,and percentage of survival at 1,5,and 10 years were examined.Overall,257 heart transplants were performed during the study period.Of the total cases,22 with incomplete data and 47 who died within 30 postoperative days were excluded for the middle-and long-term survival analyses.Of the remaining 188 patients,heart transplantation was performed(males:146,females:42).The average age of the participants was 44.43±14.48 years.The primary indications included ischemic cardiomyopathy(42.55%)and dilated cardiomyopathy(39.36%).The mean durations of mechanical ventilator support,intensive care stay,and hospital stay were 57.55±103.50 hours,9.96±8.59 days,and 19.49±18.23 days,respectively.One-,five-,and ten-year survival rates were 90.7%,71.3%,and 60.3%,respectively.Of the patients,94%and 6%were in functional classes I and II,respectively.Infection and neurological hemorrhagic or ischemic stroke(26%)were the main causes of mortality in the first year.Subsequently,chronic rejection manifesting as graft vasculopathy increased in frequency(30%).CONCLUSION In our setting,heart transplantation yields medium-and long-term survival and quality of life outcomes comparable to those achieved by other international centers.
