目的探讨在T2N0M0期低位直肠癌治疗中,应用直线切割吻合器行经肛门局部切除术联合放化疗的疗效及安全性。方法回顾性分析2017年2月至2019年2月在河北北方学院附属第一医院接受诊治的57例T2N0M0期低位直肠癌患者的临床资料,按不同手术方...目的探讨在T2N0M0期低位直肠癌治疗中,应用直线切割吻合器行经肛门局部切除术联合放化疗的疗效及安全性。方法回顾性分析2017年2月至2019年2月在河北北方学院附属第一医院接受诊治的57例T2N0M0期低位直肠癌患者的临床资料,按不同手术方式分成经肛门局部切除术联合放化疗组(TAE组,27例)和传统根治术组(RS组,30例)。比较两组患者一般资料、手术相关指标、Wexner便秘评分及生活质量量表(QLQ-C30)评分、术后并发症及随访情况。结果两组手术时间、术后住院天数、术中出血量比较,TAE组明显低于RS组,差异有统计学意义(P<0.05)。术后1个月评估,TAE组术后Wexner评分明显低于RS组(2.10±1.40 vs 6.60±2.10,t=9.041,P<0.01),QLQ-C30评分明显高于RS组(90.31±3.32 vs 71.59±6.35,t=13.716,P<0.01)。TAE组并发症发生率较RS组有所降低,但差异无统计学意义(3.70%vs 23.33%,P>0.05)。两组均随访3年及以上,仅TAE组复发1例,RS组无复发。结论对T2N0M0期低位直肠癌使用直线切割吻合器行经肛门局部切除术联合放化疗的治疗方法,可缩短手术时间、术后住院天数,减少术中出血量,改善术后排便功能及患者生活质量,不增加远期复发率。展开更多
BACKGROUND At present,there is insufficient medical evidence to determine whether adjuvant chemotherapy is necessary for T2N0M0 gastric cancer.AIM To obtain a risk score to assess the need for adjuvant chemotherapy in...BACKGROUND At present,there is insufficient medical evidence to determine whether adjuvant chemotherapy is necessary for T2N0M0 gastric cancer.AIM To obtain a risk score to assess the need for adjuvant chemotherapy in patients with T2N0M0 gastric cancer.METHODS We identified 325 patients with pathological T2N0M0 stage primary gastric cancer at the National Cancer Center between 2011 and 2018.Univariate and multivariate Cox regression analyses were performed to predict factors affecting prognosis.Vascular invasion,tumor site,and body mass index were assessed,and a scoring system was established.We compared the survival outcomes and benefits of adjuvant chemotherapy between the different subgroups.RESULTS Five-year survival rates of the score 0,1,2,and 3 groups were 92%,95%,80%,and 50%,respectively(P<0.001).In the score 2-3 group,five-year survival rates for patients in the adjuvant chemotherapy group and postoperative observation group were 95%and 61%,respectively(P=0.021).CONCLUSION For patients with T2N0M0 stage gastric cancer and two or more risk factors,adjuvant chemotherapy after D2 gastrectomy may have a survival benefit.展开更多
Objectives:The research aimed to evaluate the clinical treatment outcomes of T2N0M0 glottic laryngeal squamous cell carcinoma(LSCC)patients who underwent laryngectomy.Methods:Retrospective review of 533 T2N0M0 glottic...Objectives:The research aimed to evaluate the clinical treatment outcomes of T2N0M0 glottic laryngeal squamous cell carcinoma(LSCC)patients who underwent laryngectomy.Methods:Retrospective review of 533 T2N0M0 glottic LSCC patients.Results:Five-year cancer-specific survival(CSS)rate was 90.0%,and the overall survival(OS)rate was 89.1%.No statistically difference was found between the patients who have undergone total laryngectomy(5-year disease-free survival[DFS]=80.7%,and the CSS=86.7%)and those who have had partial laryngectomy(the 5-year DFS=85.3%,and CSS=91.1%).There was no difference in the CSS and DFS rates between patients with negative margins and those with positive margins following postoperative radiotherapy(PORT)±chemotherapy(the CSS:90.8%vs.81.8%,p=0.458 and 5-year DFS:84.6%vs.79.5%,p=0.371).Patients who underwent vertical partial laryngectomy(VPL)had better survival(5-year OS was 91.9%,and the CSS was 92.8%)than those who underwent cricohyoidoepiglottopexy(CHEP)or cricohyoidopexy(CHP)(the 5-year OS=83.8%,p=0.022 and CSS=84.9%,p=0.038).Conclusions:Surgery remains the gold standard for treating T2N0M0 glottic LSCC patients because it can achieve satisfactory oncological outcomes.Regarding the systemic conditions,the effect of partial laryngectomy is similar to that of total laryngectomy.Moreover,partial laryngectomy preserves the function of the larynx.VPL may be superior to CHP/CHEP,depending upon the invasiveness of the tumor.展开更多
文摘目的探讨在T2N0M0期低位直肠癌治疗中,应用直线切割吻合器行经肛门局部切除术联合放化疗的疗效及安全性。方法回顾性分析2017年2月至2019年2月在河北北方学院附属第一医院接受诊治的57例T2N0M0期低位直肠癌患者的临床资料,按不同手术方式分成经肛门局部切除术联合放化疗组(TAE组,27例)和传统根治术组(RS组,30例)。比较两组患者一般资料、手术相关指标、Wexner便秘评分及生活质量量表(QLQ-C30)评分、术后并发症及随访情况。结果两组手术时间、术后住院天数、术中出血量比较,TAE组明显低于RS组,差异有统计学意义(P<0.05)。术后1个月评估,TAE组术后Wexner评分明显低于RS组(2.10±1.40 vs 6.60±2.10,t=9.041,P<0.01),QLQ-C30评分明显高于RS组(90.31±3.32 vs 71.59±6.35,t=13.716,P<0.01)。TAE组并发症发生率较RS组有所降低,但差异无统计学意义(3.70%vs 23.33%,P>0.05)。两组均随访3年及以上,仅TAE组复发1例,RS组无复发。结论对T2N0M0期低位直肠癌使用直线切割吻合器行经肛门局部切除术联合放化疗的治疗方法,可缩短手术时间、术后住院天数,减少术中出血量,改善术后排便功能及患者生活质量,不增加远期复发率。
基金the National Natural Science Foundation of China,No.82072734.
文摘BACKGROUND At present,there is insufficient medical evidence to determine whether adjuvant chemotherapy is necessary for T2N0M0 gastric cancer.AIM To obtain a risk score to assess the need for adjuvant chemotherapy in patients with T2N0M0 gastric cancer.METHODS We identified 325 patients with pathological T2N0M0 stage primary gastric cancer at the National Cancer Center between 2011 and 2018.Univariate and multivariate Cox regression analyses were performed to predict factors affecting prognosis.Vascular invasion,tumor site,and body mass index were assessed,and a scoring system was established.We compared the survival outcomes and benefits of adjuvant chemotherapy between the different subgroups.RESULTS Five-year survival rates of the score 0,1,2,and 3 groups were 92%,95%,80%,and 50%,respectively(P<0.001).In the score 2-3 group,five-year survival rates for patients in the adjuvant chemotherapy group and postoperative observation group were 95%and 61%,respectively(P=0.021).CONCLUSION For patients with T2N0M0 stage gastric cancer and two or more risk factors,adjuvant chemotherapy after D2 gastrectomy may have a survival benefit.
基金sponsored by the National Natural Science Foundation of China under Grant(82003178,81772878,30801283,30972691)the Major Clinical Research Project of Shanghai Shen-kang Hospital Clinical Development Center under Grant(SHDC2020CR6011)+6 种基金the Science and Technology Innovation Project of Shanghai Shen-kang Hospital Clinical Development Center under Grant(SHDC12015114)Shanghai Sailing Program(Grant number:19YF1405900)the Shanghai Municipal Key Clinical Specialty under Grant(shslczdzk00801)the Science and Technology Committee of Shanghai under Grant(20MC1920200)the Science and Technology Commission of Shanghai Municipality under Grant(20Y11902200)the Shanghai Anti-Cancer Development Foundation under Grant(H6001-008)and the Training Program of the Excellent Doctors of Fudan University under Grant(QT00140).
文摘Objectives:The research aimed to evaluate the clinical treatment outcomes of T2N0M0 glottic laryngeal squamous cell carcinoma(LSCC)patients who underwent laryngectomy.Methods:Retrospective review of 533 T2N0M0 glottic LSCC patients.Results:Five-year cancer-specific survival(CSS)rate was 90.0%,and the overall survival(OS)rate was 89.1%.No statistically difference was found between the patients who have undergone total laryngectomy(5-year disease-free survival[DFS]=80.7%,and the CSS=86.7%)and those who have had partial laryngectomy(the 5-year DFS=85.3%,and CSS=91.1%).There was no difference in the CSS and DFS rates between patients with negative margins and those with positive margins following postoperative radiotherapy(PORT)±chemotherapy(the CSS:90.8%vs.81.8%,p=0.458 and 5-year DFS:84.6%vs.79.5%,p=0.371).Patients who underwent vertical partial laryngectomy(VPL)had better survival(5-year OS was 91.9%,and the CSS was 92.8%)than those who underwent cricohyoidoepiglottopexy(CHEP)or cricohyoidopexy(CHP)(the 5-year OS=83.8%,p=0.022 and CSS=84.9%,p=0.038).Conclusions:Surgery remains the gold standard for treating T2N0M0 glottic LSCC patients because it can achieve satisfactory oncological outcomes.Regarding the systemic conditions,the effect of partial laryngectomy is similar to that of total laryngectomy.Moreover,partial laryngectomy preserves the function of the larynx.VPL may be superior to CHP/CHEP,depending upon the invasiveness of the tumor.
