We presented an experimental apparatus combining the H-atom Rydberg tagging time-of-flight technique and the laser detonation source for studying crossed beam reactions at hyperthermal collision energies. The prelimin...We presented an experimental apparatus combining the H-atom Rydberg tagging time-of-flight technique and the laser detonation source for studying crossed beam reactions at hyperthermal collision energies. The preliminary study of the F+D2→DF+D reaction at hyperthermal collision energy of 23.84 kJ/mol was performed. Two beam sources were used in this study: one is the hyperthermal F beam source produced by a laser detonation process, and the other is D2 beam source generated by liquid-N2 cooled pulsed valve. Vibrational state-resolved di erential cross sections (DCSs) of product for the title reaction were determined. From the product vibrational state-resolved DCS, it can be concluded that products DF(v'=0, 1, 2, 3) are predominantly distributed in the sideway and backward scattering directions at this collision energy. However, the highest vibrational excited product DF(v'=4), is clearly peaked in the forward direction. The probable dynamical origins for these forward scattering products were analyzed and discussed.展开更多
Early Eocene hyperthermals are geologically short-lived global warming events and represent fundamental perturbations to the global carbon cycle and the Earth’s ecosystem due to massive additions of isotopically ligh...Early Eocene hyperthermals are geologically short-lived global warming events and represent fundamental perturbations to the global carbon cycle and the Earth’s ecosystem due to massive additions of isotopically light carbon to the ocean-atmosphere system.They serve as ancient analogs for understanding how the oceanic carbonate system and surface-ocean ecosystem would respond to ongoing and future climate change.Here,we present a continuous carbonate record across the Eocene Thermal Maximum 2(ETM2 or H1,ca.54.1 Ma)and H2(ca.54 Ma)events from an expanded section at Ocean Drilling Program Site 1258 in tropical Atlantic.The abundant calcareous nannofossils and moderate carbonate content throughout the studied interval suggest this record was deposited above the calcite compensation depth(CCD),but below the lysocline and under the influence of terrestrial dilution.An Earth system model cGENIE is used to simulate the carbon cycle dynamics across the ETM2 and H2 to offer insights on the mechanism of the rapid warming and subsequent recovery in climate and ecosystem.The model suggests moderate changes in ocean pH(0.1–0.2 unit)for the two scenarios,biogenic methane from a rechargeable methane capacitor and organic matter oxidation from thawing of the permafrost.These pH changes are consistent with a recent independent pH estimate across the ETM2 using boron isotopes.The carbon emission flux during the ETM2 is at least an order of magnitude smaller than that during the Paleocene–Eocene Thermal Maximum(PETM)(0.015–0.05 Pg C yr^(-1)vs.0.3–1.7 Pg C yr^(-1)).The comparable pre-and post-event carbonate contents suggest the lysocline did not over deepen following the ETM2 at this tropical Atlantic site,indicating spatial heterogeneity in the carbonate system due to strong dilution influence from terrestrial weathering and riverine discharge at Site 1258.展开更多
A deeper understanding of hyperthermal events in the Earth’s history can provide an important scientific basis for understanding and coping with global warming in the Anthropocene. Two types of hyperthermal events ar...A deeper understanding of hyperthermal events in the Earth’s history can provide an important scientific basis for understanding and coping with global warming in the Anthropocene. Two types of hyperthermal events are classified based on the characteristics of the carbon isotope excursion(CIE) of the five representative hyperthermal events in the Mesozoic and Cenozoic. The first type is overall characterized by negative CIEs(NCHE) and represented by the Permian-Triassic boundary event(PTB, ~252 Ma), the early Toarcian oceanic anoxic event(TOAE, ~183 Ma), and the Paleocene-Eocene Thermal Maximum event(PETM, ~56 Ma). The second type is overall characterized by positive CIEs(PCHE) and represented by the early Aptian oceanic anoxic event(OAE1 a, ~120 Ma) and the latest Cenomanian oceanic anoxic event(OAE2, ~94 Ma).Hyperthermal events of negative CIEs(NCHE), lead to dramatic changes in temperature, sedimentation, and biodiversity. These events caused frequent occurrence of terrestrial wildfires, extreme droughts, acid rain, destruction of ozone layer, metal poisoning(such as mercury), changes in terrestrial water system, and carbonate platform demise, ocean acidification, ocean anoxia in marine settings, and various degree extinction of terrestrial and marine life, especially in shallow marine. In contrast,hyperthermal events of positive CIEs(PCHE), result in rapid warming of seawater and widespread oceanic anoxia, large-scale burial of organic matter and associated black shale deposition, which exerted more significant impacts on deep-water marine life,but little impacts on shallow sea and terrestrial life. While PCHEs were triggered by volcanism associated with LIPs in deep-sea environment, the released heat and nutrient were buffered by seawater due to their eruption in the deep sea, thus exerted more significant impacts on deep-marine biota than on shallow marine and terrestrial biota. This work enriches the study of hyperthermal events in geological history, not only for the understanding of hyperthermal events themselves, large igneous provinces, marine and terrestrial environment changes, mass extinctions, but also for providing a new method to identify the types of hyperthermal events and the inference of their driving mechanism based on the characteristics of carbon isotopic excursions and geological records.展开更多
In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal Oncology.Surgical resection for peritoneal metastases from colorectal cancer(CRC)has been gradually accepted in t...In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal Oncology.Surgical resection for peritoneal metastases from colorectal cancer(CRC)has been gradually accepted in the medical oncology community.A randomized trial(PRODIGE 7)on cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal origin.Nevertheless,isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the liver.Another tool is required in those patients to achieve more local control of the disease.Surgical groups in peritoneal surgery continue to use HIPEC in their procedures,using other agents than oxaliplatin for peritoneal cavity infusion,such as mitomycin C.These patients present with complex surgical issues to manage,and consequently a large burden of complications has to be anticipated.Therefore,identifying patients who will benefit from CRS with or without HIPEC would be of great interest.展开更多
Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis.Although t...Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis.Although these treatments can be lifesaving,patients often experience a significant decrease in their overall quality of life(QoL),especially in the early stages of recovery,owing to the physical burden of surgery and the effects of chemotherapy.Many traditional QoL questionnaires have been used to measure CRS and HIPEC.However,these classical current QoL assessment tools often fail to capture the unique challenges faced by this population,including bowel dysfunction,stoma-related distress,and long-term survivorship issues.Therefore,additional parameters that assess bowel function and stoma opening status and especially patient-reported outcome measures would be useful in QoL measurements to provide a more detailed understanding of recovery and general well-being in these patients.展开更多
BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)is one of the methods to prevent peritoneal metastasis of advanced gastric cancer(AGC).However,the prognosis of gastric cancer patients who recei...BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)is one of the methods to prevent peritoneal metastasis of advanced gastric cancer(AGC).However,the prognosis of gastric cancer patients who receive this treatment are different.AIM To investigate whether inflammation and nutritional indicators affect the pro-gnosis of AGC patients undergoing gastrectomy and prophylactic HIPEC,and to develop a novel inflammatory nutritional prognostic index(INPI).Additionally,we aimed to construct a nomogram model to visually predict the prognosis of these patients and provide more accurate guidance for clinical decision-making.METHODS Clinical data from 181 Locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and least absolute shrinkage and selection operator(LASSO)Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were used to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.RESULTS Clinical data from 181 locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and LASSO Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were applied to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.CONCLUSION Inflammation and nutrition indicators are associated with the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC.The nomogram based on the INPI and clinical features supports personalized treatment strategies improving prognosis for AGC patients undergoing gastrectomy and prophylactic HIPEC.展开更多
BACKGROUND Low-grade appendiceal mucinous neoplasms are papillary or flat mucinous tumors with low-grade cytologic atypia.They are the most frequent source of pseudomyxoma peritonei.They can be easily misdiagnosed,due...BACKGROUND Low-grade appendiceal mucinous neoplasms are papillary or flat mucinous tumors with low-grade cytologic atypia.They are the most frequent source of pseudomyxoma peritonei.They can be easily misdiagnosed,due to unspecific symptoms,with acute appendicitis,retroperitoneal tumors or adnexal mass.Cases of huge appendiceal mucinous neoplasms are even more extremely rare.CASE SUMMARY We report a 54-year-old patient who presented with a 10-month history of constant dull distension accompanied by nausea.A surgical procedure of total hysterectomy,bilateral adnexectomy,appendectomy,greater omentectomy and right hemicolectomy was performed as a result of the findings on ultrasound,computed tomography scan and magnetic resonance imaging.Diagnosis was made after the pathological examination,which revealed low-grade appendiceal mucinous neoplasm.The patient received hyperthermic intraperitoneal chemotherapy with cisplatin and was discharged from the hospital.CONCLUSION Low-grade appendiceal mucinous adenomas are rare tumors that are easily misdiagnosed,and a more thorough clinical workup is required to make a defi-nitive diagnosis.展开更多
BACKGROUND Peritoneal metastases(PM)represent the most frequent and lethal form of dissemination in advanced gastric cancer(GC),with limited efficacy of systemic chemotherapy[median overall survival(OS):2-9 months].Ov...BACKGROUND Peritoneal metastases(PM)represent the most frequent and lethal form of dissemination in advanced gastric cancer(GC),with limited efficacy of systemic chemotherapy[median overall survival(OS):2-9 months].Over the past decades,hyperthermic intraperitoneal chemotherapy(HIPEC),often combined with cytoreductive surgery(CRS),has emerged as a locoregional strategy to improve peritoneal disease control.Retrospective studies have suggested promising survival benefits(median OS:18.8 months);however,conflicting results from prospective trials have limited its widespread adoption.This systematic review hypothesizes that selected patients with advanced or high-risk GC may benefit from HIPEC and evaluates whether such benefits have been confirmed in recent prospective evidence.AIM To evaluate the role and outcomes of HIPEC in advanced and high-risk GC through a systematic review of prospective trials.METHODS A systematic review of prospective randomized and controlled clinical trials(2010-2024)was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.Studies were selected from PubMed,Cochrane,Scopus,and ClinicalTrials.gov.No geographical restrictions were applied in the search process.Eligible studies included patients with advanced GC(T3+,positive peritoneal cytology/PM)receiving HIPEC in either therapeutic or prophylactic settings.Exclusion criteria included retrospective studies,single-arm trials,and those lacking survival outcomes.Risk of bias was assessed using Risk of Bias 2.0 and Risk of Bias in Non-Randomized Studies of Interventions tools;sensitivity and heterogeneity analyses were also conducted.RESULTS Thirteen prospective studies(eight therapeutic,five prophylactic)were included.In therapeutic settings,CRS combined with HIPEC yielded a median OS of 11-24.9 months vs 4-6 months with systemic therapy alone.Completeness of cytoreduction(CC-0)was achieved in 67.3%of cases,and associated with improved disease-free survival.In prophylactic settings,HIPEC significantly reduced peritoneal recurrence,particularly in T4 tumors.Sensitivity analyses confirmed robustness of findings,though benefit was driven by a few key trials.Heterogeneity was moderate across studies;lack of standardized HIPEC protocols and patient selection criteria limited comparability.CONCLUSION HIPEC may improve survival and reduce recurrence in selected GC patients,particularly those with low peritoneal burden and CC-0 resection.Further standardization and prospective trials are needed.展开更多
BACKGROUND Pseudomyxoma peritonei(PMP)is a distinct form of peritoneal malignancy characterized by diffuse intra-abdominal gelatinous ascites,with an estimated incidence of 1-3 per 1000000.PMP is predominantly seconda...BACKGROUND Pseudomyxoma peritonei(PMP)is a distinct form of peritoneal malignancy characterized by diffuse intra-abdominal gelatinous ascites,with an estimated incidence of 1-3 per 1000000.PMP is predominantly secondary to appendiceal mucinous neoplasms,with rarer origins including the ovaries,colon,and urachus.However,PMP originating from small intestine is extremely rare.CASE SUMMARY A 60-year-old male patient presented with anorexia and abdominal distension.Computed tomography revealed the presence of abdominopelvic effusions and multiple intra-abdominal space-occupying lesions.Ultrasound-guided aspiration indicated that the aspirated tissue was mucinous.Exploratory laparoscopy and tissue biopsy identified diffuse tumor nodules in peritoneum,omentum,pelvic region,intestinal walls,and mesentery.Histopathological analysis of the resected tumors confirmed the presence of mucinous adenocarcinoma,but the primary lesion was difficult to determine.The patient was referred to our center for further treatment and underwent cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)under general anesthesia.The intraoperative peritoneal cancer index was 30.The surgery lasted 8 hours,with a blood loss of about 600 mL.A complete cytoreduction(CCR0)was achieved.No serious complications occurred after surgery,and the patient’s condition was good during the telephone follow-up.Postoperative pathology confirmed the diagnosis of small intestinal mucinous adenocarcinoma at proximal jejunum,which was complicated by high-grade PMP.CONCLUSIONPMP originating from small intestine is an exceptionally rare entity that exhibits non-specific clinical features. Thepreferred treatment is CRS + HIPEC.展开更多
Patients with inflammatory bowel disease(IBD)have an increased risk of deve-loping colorectal cancer,which may ultimately result in peritoneal metastases(PM).PM in patients with IBD is by nature difficult to treat due...Patients with inflammatory bowel disease(IBD)have an increased risk of deve-loping colorectal cancer,which may ultimately result in peritoneal metastases(PM).PM in patients with IBD is by nature difficult to treat due to the chronic inflammation and immunosuppression inherent in IBD.This minireview com-piled existing evidence on management approaches to PM in patients with IBD,including surgical procedures,systemic treatment,and novel therapies.A li-terature review was conducted by searching PubMed and Scopus through June 2025 for studies addressing PM in IBD-associated colorectal or small bowel cancer.Literature specific to PM in IBD is sparse,comprising primarily two small retrospective cohort series comparing outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy(CRS/HIPEC)in patients with and without IBD.These studies indicated that in high-volume centers with careful preoperative optimization perioperative morbidity and mortality rates for patients with IBD undergoing CRS/HIPEC were similar to those without IBD.However,median overall survival(approximately 19.6-24.0 months)and disease-free survival were consistently shorter and rates of early peritoneal recurrence were higher in patients with IBD.Although CRS/HIPEC can be performed safely in selected patients with IBD and PM,long-term oncologic outcomes appear inferior compared to populations without IBD,likely reflecting later-stage pre-sentation,distinct tumor biology,and IBD-related factors.展开更多
BACKGROUND Combining cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)is a promising treatment approach for peritoneal carcinomatosis(PC).However,intraperitoneal chemotherapeutic agents si...BACKGROUND Combining cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)is a promising treatment approach for peritoneal carcinomatosis(PC).However,intraperitoneal chemotherapeutic agents significantly increase the risk of acute kidney injury(AKI).Identifying perioperative risk factors plays a critical role in preserving renal function.AIM To evaluate postoperative renal outcomes in patients with PC who underwent CRS+HIPEC.METHODS Patients who underwent CRS+HIPEC for PC between 2017 and 2024 were included in this retrospective cohort study.Demographic data,preoperative estimated glomerular filtration rate,HIPEC agents used(cisplatin,mitomycin C,oxaliplatin),intraoperative fluid management,vasopressor use,and postoperative creatinine levels were recorded.AKI was defined according to the 2012 Kidney Disease:Improving Global Outcomes criteria.Independent predictors were identified through multivariate logistic regression analysis.RESULTS AKI developed in 61 of 445 patients(13.7%).Among them,62.0%were stage I,24.6%were stage II,and 13.1%were stage III.The highest AKI rate was observed in the cisplatin group(21.4%),with lower rates in the oxaliplatin group(9.6%)and the mitomycin C group(6.5%).Independent risk factors included cisplatin use[odds ratio(OR)=2.8;95%confidence interval:1.6-4.9;P<0.001),intraoperative fluid administration<6000 mL(OR=2.1;P=0.02),vasopressor requirement(OR=1.9;P=0.03),and preoperative estimated glomerular filtration rate<75 mL/minute/1.73 m2(OR=2.3;P=0.01).AKI was associated with a prolonged hospital stay.Three patients(0.7%)progressed to chronic kidney disease.CONCLUSION Independent risk factors such as cisplatin use,inadequate fluid replacement,vasopressor requirement,and preoperative renal function should be considered during perioperative planning to reduce AKI risk following CRS+HIPEC.展开更多
Appendiceal mucinous neoplasms(AMNs)are rare tumors originating from mucin-producing epithelial cells of the appendix.They can exhibit both benign and malignant behavior.They are often incidentally discovered during a...Appendiceal mucinous neoplasms(AMNs)are rare tumors originating from mucin-producing epithelial cells of the appendix.They can exhibit both benign and malignant behavior.They are often incidentally discovered during appendectomy.Clinical presentation ranges from asymptomatic to mimicking acute appendicitis.Histologically,noninvasive AMNs are classified as low-grade AMNs(LAMNs)or high-grade AMNs(HAMNs),whereas invasive tumors are categorized as mucinous adenocarcinomas.Although LAMNs and HAMNs are generally nonmalignant,rupture can lead to pseudomyxoma peritonei(PMP).Surgical resection is the primary diagnostic and therapeutic approach,with intraoperative assessment to prevent rupture.Treatment strategies vary based on findings and include appendectomy,right hemicolectomy,and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.Histological diagnosis relies on mucin detection,and immunohistochemical markers such as cytokeratin 20(diffusely positive),cytokeratin 7(often negative),mucin 5AC,and special ATrich sequence-binding protein 2 assist in characterization.Molecular profiling frequently identifies KRAS,GNAS,and TP53 mutations.KRAS mutations are generally associated with a favorable prognosis,whereas GNAS and TP53 mutations correlate with poorer survival outcomes.These findings highlight the potential role of molecular profiling in guiding treatment strategies for AMN and PMP.展开更多
Gastric cancer with peritoneal carcinomatosis(PC)remains a formidable challenge in oncological care,especially regarding surgical intervention.Integrating enhanced recovery after surgery(ERAS)protocols into gastrectom...Gastric cancer with peritoneal carcinomatosis(PC)remains a formidable challenge in oncological care,especially regarding surgical intervention.Integrating enhanced recovery after surgery(ERAS)protocols into gastrectomy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy has emerged as a promising approach.This minireview explores the influence of ERAS on surgical and oncological outcomes in this multifaceted procedure.Recent evidence suggests that ERAS,comprising multimodal strategies,improves postoperative recovery,reduces complications,and enhances quality of life.It may also contribute to better survival outcomes by minimizing perioperative morbidity and thereby facilitating the timely initiation of adjuvant therapy.Mechanistically,ERAS promotes early mobilization,attenuates postoperative immunosuppression,and supports timely adjuvant therapies,which are crucial in managing carcinomatosis.This minireview underscores the importance of multidisciplinary collaboration and individualized patient care to maximize ERAS benefits.Large-scale,prospective investigations are warranted to validate these findings and refine ERAS protocols for this specialized patient cohort.Further research will facilitate ongoing advancements in oncological surgery and perioperative care,ultimately improving outcomes for patients with gastric cancer and PC.展开更多
BACKGROUND Cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)has become an established treatment for selected patients with peritoneal metastases(PM)from colorectal,ovarian,and ga...BACKGROUND Cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)has become an established treatment for selected patients with peritoneal metastases(PM)from colorectal,ovarian,and gastric cancers,as well as for certain primary peritoneal tumors such as pseudomyxoma peritonei.However,evidence supporting its role in other uncommon indications remains limited,largely due to the rarity and heterogeneity of these malignancies and the absence of standardized treatment protocols.Understanding the potential survival benefit and safety profile of CRS+HIPEC in these contexts may help refine patient selection and guide clinical decision-making.AIM To evaluate surgical and oncologic outcomes,particularly overall survival(OS),in this heterogeneous patient population and assess perioperative morbidity and mortality to better define the safety profile of this aggressive multimodal strategy.METHODS We retrospectively reviewed data from five tertiary cancer centers on patients who underwent CRS+HIPEC between January 2004 and December 2021 for PM from uncommon histologies,defined as any primary tumor other than colorectal,gastric,or ovarian carcinomas,pseudomyxoma peritonei,or malignant peritoneal mesothelioma.Baseline characteristics,operative details,complications(graded by the Clavien-Dindo classification),and survival outcomes were analyzed.OS was estimated using Kaplan-Meier analysis.Prognostic factors were evaluated using univariate and multivariate Cox proportional hazards models.The discriminatory ability and overall fit of the final model were assessed by the concordance index(C-index)and likelihood ratio test,respectively.RESULTS A total of 60 CRS+HIPEC procedures were performed in 60 patients(mean age=58.5 years,78.3%female).The most frequent primary tumors were uterine(35%)and breast cancer(20%).Median operative time was 405 minutes,and 75%of patients required perioperative transfusions.Major complications(Clavien-Dindo≥3)occurred in 21.6%of patients,and 90-day mortality was 1.6%.Median OS for the entire cohort was 28 months.Kaplan-Meier analysis showed that breast cancer patients achieved the longest survival(median OS=75 months)compared with uterine cancer(32 months)and other primaries(17 months).Multivariate analysis confirmed tumor origin as the strongest independent predictor of OS(C-index=0.81;likelihood ratio test=40.07;P<0.001).CONCLUSION Our findings suggest that CRS+HIPEC can be performed safely in highly selected patients with PM from uncommon primary tumors,achieving meaningful long-term survival in subsets such as breast and uterine cancers.Tumor biology,rather than clinical factors,emerged as the key determinant of survival.Given the rarity and heterogeneity of these malignancies,collaborative multicenter efforts and prospective registries are essential to establish standardized selection criteria and optimize outcomes.展开更多
AIM To investigate the response to hyperthermia and chemotherapy, analyzing apoptosis, cytotoxicity, and cisplatin concentration in different digestive system cancer cells.METHODS AGS(gastric cancer cell line), Caco-2...AIM To investigate the response to hyperthermia and chemotherapy, analyzing apoptosis, cytotoxicity, and cisplatin concentration in different digestive system cancer cells.METHODS AGS(gastric cancer cell line), Caco-2(colon cancer cell line) and T3M4(pancreatic cancer cell line) were treated by cisplatin and different temperature setting(37 ℃ to 45 ℃) either in isolation, or in combination. Treatment lasted for one hour. 48 h after the treatment viability was evaluated by MTT, cell apoptosis by Annexin V-PE and 7 ADD flow cytometry. Intracellular cisplatin concentration was measured immediately after the treatment, using mass spectrometry. Isobologram analysis was performed to evaluate the mathematical combined effect of temperature and cisplatin.RESULTS AGS cells were the most sensitive to isolated application of hyperthermia. Hyperthermia, in addition to cisplatin treatment, did not provoke a synergistic effect at intervals from 37 ℃ to 41 ℃ in neither cancer cell line. However, a temperature of 43 ℃ enhanced cisplatin cytotoxicity for Caco-2 cells. Moreover, isobologram analysis revealed mathematical antagonistic effects of cisplatin and temperature combined treatment in AGS cells; variations between synergistic, additive, and antagonistic effects in Caco-2 cells; and additive and antagonistic effects in T3 M4 cells. Combined treatment enhanced initiation of cell apoptosis in AGS, Caco-2, and T3 M4 cells by 61%, 20%, and 19% respectively. The increase of intracellular cisplatin concentration was observed at 43 ℃ by 30%, 20%, and 18% in AGS, Caco-2, and T3 M4 cells, respectively.CONCLUSION In addition to cisplatin, hyperthermia up to 43 ℃ does not affect the viability of cancer cells in a synergistic manner.展开更多
Hyperthermal environments can harm workers’health and safety.However,it is difficult to include effective protection into standards because heat-related impacts vary significantly accord-ing to individual workers and...Hyperthermal environments can harm workers’health and safety.However,it is difficult to include effective protection into standards because heat-related impacts vary significantly accord-ing to individual workers and multiple factors.Studies suggested obvious relationship between en-vironment condition and bio-electricity signal,including electroencephalogram(EEG)signal.We used a detector with 64 electrodes to perform dedicated EEG measurements of nine individual sub-jects to analyze human cerebral activity under hyperthermal(35℃,80%RH)and standard condi-tions(25℃,30%RH).Amplitude changes of the frequency wavebands were analyzed using statist-ical analysis.Seven participants showed increasing beta activity due to high temperature and high humidity in the primary somatosensory cortex(electrode C3)and the temporopolar region(elec-trode FT 8).The amplitude value of alpha wave is increased from 0.194 to 0.213 while the amp-litude value of beta wave is increased from 0.144 to 0.160.Value is decreased due to hyperthermal environment for most people.The results of this study could be used to inform the development of wearable equipment to monitor the health of on-site workers,which is fundamental to improve worker safety and wellbeing.展开更多
Gastric cancer associated peritoneal carcinomatosis(GCPC) has a poor prognosis with a median survival of less than one year. Systemic chemotherapy including targeted agents has not been found to significantly increase...Gastric cancer associated peritoneal carcinomatosis(GCPC) has a poor prognosis with a median survival of less than one year. Systemic chemotherapy including targeted agents has not been found to significantly increase the survival in GCPC. Since recurrent gastric cancer remains confined to the abdominal cavity in many patients, regional therapies like aggressive cytoreductive surgery( CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) have been investigated for GCPC. HIPEC has been used for three indications in GC- as an adjuvant therapy after a curative surgery, HIPEC has been shown to improve survival and reduce peritoneal recurrences in many randomised trials in Asian countries; as a definitive treatment in established PC, HIPEC along with CRS is the only therapeutic modality that has resulted in longterm survival in select groups of patients; as a palliative treatment in advanced PC with intractable ascites, HIPEC has been shown to control ascites and reduce the need for frequent paracentesis. While the results of randomised trials of adjuvant HIPEC from western centres are awaited, the role of HIPEC in the treatment of GCPC is still evolving and needs larger studies before it is accepted as a standard of care.展开更多
AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritone...AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC is a safe, feasible and effective procedure in the treatment of debilitating malignant ascites induced by unresectable gastric cancers.展开更多
This article is to offer a concise review on the use of cytoreductive surgery （CRS） plus intraperitoneal hyperthermic chemotherapy （IPHC） for the treatment of peritoneal carcinomatosis （PC）. Traditionally, PC wa...This article is to offer a concise review on the use of cytoreductive surgery （CRS） plus intraperitoneal hyperthermic chemotherapy （IPHC） for the treatment of peritoneal carcinomatosis （PC）. Traditionally, PC was treated with systemic chemotherapy alone with very poor response and a median survival of less than 6 too. With the establishment of several phase Ⅱ studies, a new trend has been developed toward the use of CRS plus IPHC as a standard method for treating selected patients with PC, in whom sufficient cytoreduction could be achieved. In spite of the need for more high quality phase Ⅲ studies, there is now a consensus among many surgical oncology experts throughout the world about the use of this new treatment strategy as standard care for colorectal cancer patients with PC. This review summarizes the current status and possible progress in future.展开更多
The incidence of gastric cancer(GC) is decreasing worldwide,especially for intestinal histotype of the distal third of the stomach.On the contrary,proximal location and diffuse Lauren histotype have been reported to b...The incidence of gastric cancer(GC) is decreasing worldwide,especially for intestinal histotype of the distal third of the stomach.On the contrary,proximal location and diffuse Lauren histotype have been reported to be generally stable over time.In the west,no clear improvement in long-term results was observed in clinical and population-based studies.Results of treatment in these neoplasms are strictly dependent on tumor stage.Adequate surgery and extended lymphadenectomy are associated with good long-term outcome in early-stage cancer; however,results are still unsatisfactory for advanced stages(Ⅲ and Ⅳ),for which additional treatments could provide a survival benefit.This implies a tailored approach to GC.The aim of this review was to summarize the main multimodal treatment options in advanced resectable GC.Perioperative or postoperative treatments,including chemotherapy,chemoradiotherapy,targeted therapies,and hyperthermic intraperitoneal chemotherapy have been reviewed,and the main ongoing and completed trials have been analyzed.An original tailored multimodal approach to non-cardia GC has been also proposed.展开更多
基金supported by the National Natural Science Foundation of China (No.21473015, No.21203016, No.41574101, No.21673232, No.21773213)the Foundation for the Author of National Excellent Doctoral Dissertation of China (No.201222)
文摘We presented an experimental apparatus combining the H-atom Rydberg tagging time-of-flight technique and the laser detonation source for studying crossed beam reactions at hyperthermal collision energies. The preliminary study of the F+D2→DF+D reaction at hyperthermal collision energy of 23.84 kJ/mol was performed. Two beam sources were used in this study: one is the hyperthermal F beam source produced by a laser detonation process, and the other is D2 beam source generated by liquid-N2 cooled pulsed valve. Vibrational state-resolved di erential cross sections (DCSs) of product for the title reaction were determined. From the product vibrational state-resolved DCS, it can be concluded that products DF(v'=0, 1, 2, 3) are predominantly distributed in the sideway and backward scattering directions at this collision energy. However, the highest vibrational excited product DF(v'=4), is clearly peaked in the forward direction. The probable dynamical origins for these forward scattering products were analyzed and discussed.
基金This study was supported by the National Natural Science Foundation of China(Grant Nos.41976045&41888101)and the Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai)through a group research project(99147-42080024).Y.Cui is supported by the U.S.National Science Foundation award 1603051.Samples and core data were provided by ODP.ODP is sponsored by the U.S.National Science Foundation(NSF)and participating countries under management of Joint Oceanographic Institutions(JOI),Inc.
文摘Early Eocene hyperthermals are geologically short-lived global warming events and represent fundamental perturbations to the global carbon cycle and the Earth’s ecosystem due to massive additions of isotopically light carbon to the ocean-atmosphere system.They serve as ancient analogs for understanding how the oceanic carbonate system and surface-ocean ecosystem would respond to ongoing and future climate change.Here,we present a continuous carbonate record across the Eocene Thermal Maximum 2(ETM2 or H1,ca.54.1 Ma)and H2(ca.54 Ma)events from an expanded section at Ocean Drilling Program Site 1258 in tropical Atlantic.The abundant calcareous nannofossils and moderate carbonate content throughout the studied interval suggest this record was deposited above the calcite compensation depth(CCD),but below the lysocline and under the influence of terrestrial dilution.An Earth system model cGENIE is used to simulate the carbon cycle dynamics across the ETM2 and H2 to offer insights on the mechanism of the rapid warming and subsequent recovery in climate and ecosystem.The model suggests moderate changes in ocean pH(0.1–0.2 unit)for the two scenarios,biogenic methane from a rechargeable methane capacitor and organic matter oxidation from thawing of the permafrost.These pH changes are consistent with a recent independent pH estimate across the ETM2 using boron isotopes.The carbon emission flux during the ETM2 is at least an order of magnitude smaller than that during the Paleocene–Eocene Thermal Maximum(PETM)(0.015–0.05 Pg C yr^(-1)vs.0.3–1.7 Pg C yr^(-1)).The comparable pre-and post-event carbonate contents suggest the lysocline did not over deepen following the ETM2 at this tropical Atlantic site,indicating spatial heterogeneity in the carbonate system due to strong dilution influence from terrestrial weathering and riverine discharge at Site 1258.
基金financially supported by the National Natural Science Foundation of China (Grant No. 41888101)National Natural Science Fund for Distinguished Young Scholars (Grant No. 41525007)。
文摘A deeper understanding of hyperthermal events in the Earth’s history can provide an important scientific basis for understanding and coping with global warming in the Anthropocene. Two types of hyperthermal events are classified based on the characteristics of the carbon isotope excursion(CIE) of the five representative hyperthermal events in the Mesozoic and Cenozoic. The first type is overall characterized by negative CIEs(NCHE) and represented by the Permian-Triassic boundary event(PTB, ~252 Ma), the early Toarcian oceanic anoxic event(TOAE, ~183 Ma), and the Paleocene-Eocene Thermal Maximum event(PETM, ~56 Ma). The second type is overall characterized by positive CIEs(PCHE) and represented by the early Aptian oceanic anoxic event(OAE1 a, ~120 Ma) and the latest Cenomanian oceanic anoxic event(OAE2, ~94 Ma).Hyperthermal events of negative CIEs(NCHE), lead to dramatic changes in temperature, sedimentation, and biodiversity. These events caused frequent occurrence of terrestrial wildfires, extreme droughts, acid rain, destruction of ozone layer, metal poisoning(such as mercury), changes in terrestrial water system, and carbonate platform demise, ocean acidification, ocean anoxia in marine settings, and various degree extinction of terrestrial and marine life, especially in shallow marine. In contrast,hyperthermal events of positive CIEs(PCHE), result in rapid warming of seawater and widespread oceanic anoxia, large-scale burial of organic matter and associated black shale deposition, which exerted more significant impacts on deep-water marine life,but little impacts on shallow sea and terrestrial life. While PCHEs were triggered by volcanism associated with LIPs in deep-sea environment, the released heat and nutrient were buffered by seawater due to their eruption in the deep sea, thus exerted more significant impacts on deep-marine biota than on shallow marine and terrestrial biota. This work enriches the study of hyperthermal events in geological history, not only for the understanding of hyperthermal events themselves, large igneous provinces, marine and terrestrial environment changes, mass extinctions, but also for providing a new method to identify the types of hyperthermal events and the inference of their driving mechanism based on the characteristics of carbon isotopic excursions and geological records.
文摘In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal Oncology.Surgical resection for peritoneal metastases from colorectal cancer(CRC)has been gradually accepted in the medical oncology community.A randomized trial(PRODIGE 7)on cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal origin.Nevertheless,isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the liver.Another tool is required in those patients to achieve more local control of the disease.Surgical groups in peritoneal surgery continue to use HIPEC in their procedures,using other agents than oxaliplatin for peritoneal cavity infusion,such as mitomycin C.These patients present with complex surgical issues to manage,and consequently a large burden of complications has to be anticipated.Therefore,identifying patients who will benefit from CRS with or without HIPEC would be of great interest.
文摘Cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)are complex surgical procedures that are often used to treat advanced cancers of the abdominal cavity with peritoneal metastasis.Although these treatments can be lifesaving,patients often experience a significant decrease in their overall quality of life(QoL),especially in the early stages of recovery,owing to the physical burden of surgery and the effects of chemotherapy.Many traditional QoL questionnaires have been used to measure CRS and HIPEC.However,these classical current QoL assessment tools often fail to capture the unique challenges faced by this population,including bowel dysfunction,stoma-related distress,and long-term survivorship issues.Therefore,additional parameters that assess bowel function and stoma opening status and especially patient-reported outcome measures would be useful in QoL measurements to provide a more detailed understanding of recovery and general well-being in these patients.
文摘BACKGROUND Prophylactic hyperthermic intraperitoneal chemotherapy(HIPEC)is one of the methods to prevent peritoneal metastasis of advanced gastric cancer(AGC).However,the prognosis of gastric cancer patients who receive this treatment are different.AIM To investigate whether inflammation and nutritional indicators affect the pro-gnosis of AGC patients undergoing gastrectomy and prophylactic HIPEC,and to develop a novel inflammatory nutritional prognostic index(INPI).Additionally,we aimed to construct a nomogram model to visually predict the prognosis of these patients and provide more accurate guidance for clinical decision-making.METHODS Clinical data from 181 Locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and least absolute shrinkage and selection operator(LASSO)Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were used to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.RESULTS Clinical data from 181 locally AGC patients who underwent gastrectomy and prophylactic HIPEC treatment at The Affiliated Hospital of Qingdao University were retrospectively collected.Multicollinearity analysis and LASSO Cox regression were utilized to construct the INPI.Survival analyses were performed using the Kaplan-Meier method and log-rank test.Both univariate and multivariate Cox proportional hazards regression models were applied to analyze independent prognostic factors,and a prognostic nomogram was generated.And the model was validated using the bootstrap method.CONCLUSION Inflammation and nutrition indicators are associated with the prognosis of AGC patients undergoing gastrectomy and prophylactic HIPEC.The nomogram based on the INPI and clinical features supports personalized treatment strategies improving prognosis for AGC patients undergoing gastrectomy and prophylactic HIPEC.
基金Supported by the National Natural Science Foundation of China,No.82204123.
文摘BACKGROUND Low-grade appendiceal mucinous neoplasms are papillary or flat mucinous tumors with low-grade cytologic atypia.They are the most frequent source of pseudomyxoma peritonei.They can be easily misdiagnosed,due to unspecific symptoms,with acute appendicitis,retroperitoneal tumors or adnexal mass.Cases of huge appendiceal mucinous neoplasms are even more extremely rare.CASE SUMMARY We report a 54-year-old patient who presented with a 10-month history of constant dull distension accompanied by nausea.A surgical procedure of total hysterectomy,bilateral adnexectomy,appendectomy,greater omentectomy and right hemicolectomy was performed as a result of the findings on ultrasound,computed tomography scan and magnetic resonance imaging.Diagnosis was made after the pathological examination,which revealed low-grade appendiceal mucinous neoplasm.The patient received hyperthermic intraperitoneal chemotherapy with cisplatin and was discharged from the hospital.CONCLUSION Low-grade appendiceal mucinous adenomas are rare tumors that are easily misdiagnosed,and a more thorough clinical workup is required to make a defi-nitive diagnosis.
文摘BACKGROUND Peritoneal metastases(PM)represent the most frequent and lethal form of dissemination in advanced gastric cancer(GC),with limited efficacy of systemic chemotherapy[median overall survival(OS):2-9 months].Over the past decades,hyperthermic intraperitoneal chemotherapy(HIPEC),often combined with cytoreductive surgery(CRS),has emerged as a locoregional strategy to improve peritoneal disease control.Retrospective studies have suggested promising survival benefits(median OS:18.8 months);however,conflicting results from prospective trials have limited its widespread adoption.This systematic review hypothesizes that selected patients with advanced or high-risk GC may benefit from HIPEC and evaluates whether such benefits have been confirmed in recent prospective evidence.AIM To evaluate the role and outcomes of HIPEC in advanced and high-risk GC through a systematic review of prospective trials.METHODS A systematic review of prospective randomized and controlled clinical trials(2010-2024)was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.Studies were selected from PubMed,Cochrane,Scopus,and ClinicalTrials.gov.No geographical restrictions were applied in the search process.Eligible studies included patients with advanced GC(T3+,positive peritoneal cytology/PM)receiving HIPEC in either therapeutic or prophylactic settings.Exclusion criteria included retrospective studies,single-arm trials,and those lacking survival outcomes.Risk of bias was assessed using Risk of Bias 2.0 and Risk of Bias in Non-Randomized Studies of Interventions tools;sensitivity and heterogeneity analyses were also conducted.RESULTS Thirteen prospective studies(eight therapeutic,five prophylactic)were included.In therapeutic settings,CRS combined with HIPEC yielded a median OS of 11-24.9 months vs 4-6 months with systemic therapy alone.Completeness of cytoreduction(CC-0)was achieved in 67.3%of cases,and associated with improved disease-free survival.In prophylactic settings,HIPEC significantly reduced peritoneal recurrence,particularly in T4 tumors.Sensitivity analyses confirmed robustness of findings,though benefit was driven by a few key trials.Heterogeneity was moderate across studies;lack of standardized HIPEC protocols and patient selection criteria limited comparability.CONCLUSION HIPEC may improve survival and reduce recurrence in selected GC patients,particularly those with low peritoneal burden and CC-0 resection.Further standardization and prospective trials are needed.
基金Supported by 2024 Aerospace Center Hospital Scientific Research Fund,No.YN202410.
文摘BACKGROUND Pseudomyxoma peritonei(PMP)is a distinct form of peritoneal malignancy characterized by diffuse intra-abdominal gelatinous ascites,with an estimated incidence of 1-3 per 1000000.PMP is predominantly secondary to appendiceal mucinous neoplasms,with rarer origins including the ovaries,colon,and urachus.However,PMP originating from small intestine is extremely rare.CASE SUMMARY A 60-year-old male patient presented with anorexia and abdominal distension.Computed tomography revealed the presence of abdominopelvic effusions and multiple intra-abdominal space-occupying lesions.Ultrasound-guided aspiration indicated that the aspirated tissue was mucinous.Exploratory laparoscopy and tissue biopsy identified diffuse tumor nodules in peritoneum,omentum,pelvic region,intestinal walls,and mesentery.Histopathological analysis of the resected tumors confirmed the presence of mucinous adenocarcinoma,but the primary lesion was difficult to determine.The patient was referred to our center for further treatment and underwent cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)under general anesthesia.The intraoperative peritoneal cancer index was 30.The surgery lasted 8 hours,with a blood loss of about 600 mL.A complete cytoreduction(CCR0)was achieved.No serious complications occurred after surgery,and the patient’s condition was good during the telephone follow-up.Postoperative pathology confirmed the diagnosis of small intestinal mucinous adenocarcinoma at proximal jejunum,which was complicated by high-grade PMP.CONCLUSIONPMP originating from small intestine is an exceptionally rare entity that exhibits non-specific clinical features. Thepreferred treatment is CRS + HIPEC.
文摘Patients with inflammatory bowel disease(IBD)have an increased risk of deve-loping colorectal cancer,which may ultimately result in peritoneal metastases(PM).PM in patients with IBD is by nature difficult to treat due to the chronic inflammation and immunosuppression inherent in IBD.This minireview com-piled existing evidence on management approaches to PM in patients with IBD,including surgical procedures,systemic treatment,and novel therapies.A li-terature review was conducted by searching PubMed and Scopus through June 2025 for studies addressing PM in IBD-associated colorectal or small bowel cancer.Literature specific to PM in IBD is sparse,comprising primarily two small retrospective cohort series comparing outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy(CRS/HIPEC)in patients with and without IBD.These studies indicated that in high-volume centers with careful preoperative optimization perioperative morbidity and mortality rates for patients with IBD undergoing CRS/HIPEC were similar to those without IBD.However,median overall survival(approximately 19.6-24.0 months)and disease-free survival were consistently shorter and rates of early peritoneal recurrence were higher in patients with IBD.Although CRS/HIPEC can be performed safely in selected patients with IBD and PM,long-term oncologic outcomes appear inferior compared to populations without IBD,likely reflecting later-stage pre-sentation,distinct tumor biology,and IBD-related factors.
文摘BACKGROUND Combining cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)is a promising treatment approach for peritoneal carcinomatosis(PC).However,intraperitoneal chemotherapeutic agents significantly increase the risk of acute kidney injury(AKI).Identifying perioperative risk factors plays a critical role in preserving renal function.AIM To evaluate postoperative renal outcomes in patients with PC who underwent CRS+HIPEC.METHODS Patients who underwent CRS+HIPEC for PC between 2017 and 2024 were included in this retrospective cohort study.Demographic data,preoperative estimated glomerular filtration rate,HIPEC agents used(cisplatin,mitomycin C,oxaliplatin),intraoperative fluid management,vasopressor use,and postoperative creatinine levels were recorded.AKI was defined according to the 2012 Kidney Disease:Improving Global Outcomes criteria.Independent predictors were identified through multivariate logistic regression analysis.RESULTS AKI developed in 61 of 445 patients(13.7%).Among them,62.0%were stage I,24.6%were stage II,and 13.1%were stage III.The highest AKI rate was observed in the cisplatin group(21.4%),with lower rates in the oxaliplatin group(9.6%)and the mitomycin C group(6.5%).Independent risk factors included cisplatin use[odds ratio(OR)=2.8;95%confidence interval:1.6-4.9;P<0.001),intraoperative fluid administration<6000 mL(OR=2.1;P=0.02),vasopressor requirement(OR=1.9;P=0.03),and preoperative estimated glomerular filtration rate<75 mL/minute/1.73 m2(OR=2.3;P=0.01).AKI was associated with a prolonged hospital stay.Three patients(0.7%)progressed to chronic kidney disease.CONCLUSION Independent risk factors such as cisplatin use,inadequate fluid replacement,vasopressor requirement,and preoperative renal function should be considered during perioperative planning to reduce AKI risk following CRS+HIPEC.
文摘Appendiceal mucinous neoplasms(AMNs)are rare tumors originating from mucin-producing epithelial cells of the appendix.They can exhibit both benign and malignant behavior.They are often incidentally discovered during appendectomy.Clinical presentation ranges from asymptomatic to mimicking acute appendicitis.Histologically,noninvasive AMNs are classified as low-grade AMNs(LAMNs)or high-grade AMNs(HAMNs),whereas invasive tumors are categorized as mucinous adenocarcinomas.Although LAMNs and HAMNs are generally nonmalignant,rupture can lead to pseudomyxoma peritonei(PMP).Surgical resection is the primary diagnostic and therapeutic approach,with intraoperative assessment to prevent rupture.Treatment strategies vary based on findings and include appendectomy,right hemicolectomy,and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.Histological diagnosis relies on mucin detection,and immunohistochemical markers such as cytokeratin 20(diffusely positive),cytokeratin 7(often negative),mucin 5AC,and special ATrich sequence-binding protein 2 assist in characterization.Molecular profiling frequently identifies KRAS,GNAS,and TP53 mutations.KRAS mutations are generally associated with a favorable prognosis,whereas GNAS and TP53 mutations correlate with poorer survival outcomes.These findings highlight the potential role of molecular profiling in guiding treatment strategies for AMN and PMP.
文摘Gastric cancer with peritoneal carcinomatosis(PC)remains a formidable challenge in oncological care,especially regarding surgical intervention.Integrating enhanced recovery after surgery(ERAS)protocols into gastrectomy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy has emerged as a promising approach.This minireview explores the influence of ERAS on surgical and oncological outcomes in this multifaceted procedure.Recent evidence suggests that ERAS,comprising multimodal strategies,improves postoperative recovery,reduces complications,and enhances quality of life.It may also contribute to better survival outcomes by minimizing perioperative morbidity and thereby facilitating the timely initiation of adjuvant therapy.Mechanistically,ERAS promotes early mobilization,attenuates postoperative immunosuppression,and supports timely adjuvant therapies,which are crucial in managing carcinomatosis.This minireview underscores the importance of multidisciplinary collaboration and individualized patient care to maximize ERAS benefits.Large-scale,prospective investigations are warranted to validate these findings and refine ERAS protocols for this specialized patient cohort.Further research will facilitate ongoing advancements in oncological surgery and perioperative care,ultimately improving outcomes for patients with gastric cancer and PC.
文摘BACKGROUND Cytoreductive surgery(CRS)combined with hyperthermic intraperitoneal chemotherapy(HIPEC)has become an established treatment for selected patients with peritoneal metastases(PM)from colorectal,ovarian,and gastric cancers,as well as for certain primary peritoneal tumors such as pseudomyxoma peritonei.However,evidence supporting its role in other uncommon indications remains limited,largely due to the rarity and heterogeneity of these malignancies and the absence of standardized treatment protocols.Understanding the potential survival benefit and safety profile of CRS+HIPEC in these contexts may help refine patient selection and guide clinical decision-making.AIM To evaluate surgical and oncologic outcomes,particularly overall survival(OS),in this heterogeneous patient population and assess perioperative morbidity and mortality to better define the safety profile of this aggressive multimodal strategy.METHODS We retrospectively reviewed data from five tertiary cancer centers on patients who underwent CRS+HIPEC between January 2004 and December 2021 for PM from uncommon histologies,defined as any primary tumor other than colorectal,gastric,or ovarian carcinomas,pseudomyxoma peritonei,or malignant peritoneal mesothelioma.Baseline characteristics,operative details,complications(graded by the Clavien-Dindo classification),and survival outcomes were analyzed.OS was estimated using Kaplan-Meier analysis.Prognostic factors were evaluated using univariate and multivariate Cox proportional hazards models.The discriminatory ability and overall fit of the final model were assessed by the concordance index(C-index)and likelihood ratio test,respectively.RESULTS A total of 60 CRS+HIPEC procedures were performed in 60 patients(mean age=58.5 years,78.3%female).The most frequent primary tumors were uterine(35%)and breast cancer(20%).Median operative time was 405 minutes,and 75%of patients required perioperative transfusions.Major complications(Clavien-Dindo≥3)occurred in 21.6%of patients,and 90-day mortality was 1.6%.Median OS for the entire cohort was 28 months.Kaplan-Meier analysis showed that breast cancer patients achieved the longest survival(median OS=75 months)compared with uterine cancer(32 months)and other primaries(17 months).Multivariate analysis confirmed tumor origin as the strongest independent predictor of OS(C-index=0.81;likelihood ratio test=40.07;P<0.001).CONCLUSION Our findings suggest that CRS+HIPEC can be performed safely in highly selected patients with PM from uncommon primary tumors,achieving meaningful long-term survival in subsets such as breast and uterine cancers.Tumor biology,rather than clinical factors,emerged as the key determinant of survival.Given the rarity and heterogeneity of these malignancies,collaborative multicenter efforts and prospective registries are essential to establish standardized selection criteria and optimize outcomes.
基金Supported by the Research Council of Lithuania,No.SEN-01/2015
文摘AIM To investigate the response to hyperthermia and chemotherapy, analyzing apoptosis, cytotoxicity, and cisplatin concentration in different digestive system cancer cells.METHODS AGS(gastric cancer cell line), Caco-2(colon cancer cell line) and T3M4(pancreatic cancer cell line) were treated by cisplatin and different temperature setting(37 ℃ to 45 ℃) either in isolation, or in combination. Treatment lasted for one hour. 48 h after the treatment viability was evaluated by MTT, cell apoptosis by Annexin V-PE and 7 ADD flow cytometry. Intracellular cisplatin concentration was measured immediately after the treatment, using mass spectrometry. Isobologram analysis was performed to evaluate the mathematical combined effect of temperature and cisplatin.RESULTS AGS cells were the most sensitive to isolated application of hyperthermia. Hyperthermia, in addition to cisplatin treatment, did not provoke a synergistic effect at intervals from 37 ℃ to 41 ℃ in neither cancer cell line. However, a temperature of 43 ℃ enhanced cisplatin cytotoxicity for Caco-2 cells. Moreover, isobologram analysis revealed mathematical antagonistic effects of cisplatin and temperature combined treatment in AGS cells; variations between synergistic, additive, and antagonistic effects in Caco-2 cells; and additive and antagonistic effects in T3 M4 cells. Combined treatment enhanced initiation of cell apoptosis in AGS, Caco-2, and T3 M4 cells by 61%, 20%, and 19% respectively. The increase of intracellular cisplatin concentration was observed at 43 ℃ by 30%, 20%, and 18% in AGS, Caco-2, and T3 M4 cells, respectively.CONCLUSION In addition to cisplatin, hyperthermia up to 43 ℃ does not affect the viability of cancer cells in a synergistic manner.
基金the Fundamental Research Funds for the Central Universities(Nos.FRF-IDRY-19-009,FRF-TP-19-038A1).
文摘Hyperthermal environments can harm workers’health and safety.However,it is difficult to include effective protection into standards because heat-related impacts vary significantly accord-ing to individual workers and multiple factors.Studies suggested obvious relationship between en-vironment condition and bio-electricity signal,including electroencephalogram(EEG)signal.We used a detector with 64 electrodes to perform dedicated EEG measurements of nine individual sub-jects to analyze human cerebral activity under hyperthermal(35℃,80%RH)and standard condi-tions(25℃,30%RH).Amplitude changes of the frequency wavebands were analyzed using statist-ical analysis.Seven participants showed increasing beta activity due to high temperature and high humidity in the primary somatosensory cortex(electrode C3)and the temporopolar region(elec-trode FT 8).The amplitude value of alpha wave is increased from 0.194 to 0.213 while the amp-litude value of beta wave is increased from 0.144 to 0.160.Value is decreased due to hyperthermal environment for most people.The results of this study could be used to inform the development of wearable equipment to monitor the health of on-site workers,which is fundamental to improve worker safety and wellbeing.
文摘Gastric cancer associated peritoneal carcinomatosis(GCPC) has a poor prognosis with a median survival of less than one year. Systemic chemotherapy including targeted agents has not been found to significantly increase the survival in GCPC. Since recurrent gastric cancer remains confined to the abdominal cavity in many patients, regional therapies like aggressive cytoreductive surgery( CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) have been investigated for GCPC. HIPEC has been used for three indications in GC- as an adjuvant therapy after a curative surgery, HIPEC has been shown to improve survival and reduce peritoneal recurrences in many randomised trials in Asian countries; as a definitive treatment in established PC, HIPEC along with CRS is the only therapeutic modality that has resulted in longterm survival in select groups of patients; as a palliative treatment in advanced PC with intractable ascites, HIPEC has been shown to control ascites and reduce the need for frequent paracentesis. While the results of randomised trials of adjuvant HIPEC from western centres are awaited, the role of HIPEC in the treatment of GCPC is still evolving and needs larger studies before it is accepted as a standard of care.
基金Supported by Funds for Breakthroughs in Key Areas of Guang-dong and Hong Kong Projects, No. 2006Z1-E6041funds for Guangdong Provincial Science and Technology Programs, No. 2009A030301013
文摘AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC is a safe, feasible and effective procedure in the treatment of debilitating malignant ascites induced by unresectable gastric cancers.
基金New-Century Excellent Talents Supporting Program of the Ministry of Education of China NCET-04-0669Foundation for the Author of National Excellent Doctoral Dissertation of China+2 种基金 FANEDD-200464Young Talents Supporting Program of Hubei Province 301161202National Natural Science Foundation of China No. 20675058
文摘This article is to offer a concise review on the use of cytoreductive surgery （CRS） plus intraperitoneal hyperthermic chemotherapy （IPHC） for the treatment of peritoneal carcinomatosis （PC）. Traditionally, PC was treated with systemic chemotherapy alone with very poor response and a median survival of less than 6 too. With the establishment of several phase Ⅱ studies, a new trend has been developed toward the use of CRS plus IPHC as a standard method for treating selected patients with PC, in whom sufficient cytoreduction could be achieved. In spite of the need for more high quality phase Ⅲ studies, there is now a consensus among many surgical oncology experts throughout the world about the use of this new treatment strategy as standard care for colorectal cancer patients with PC. This review summarizes the current status and possible progress in future.
文摘The incidence of gastric cancer(GC) is decreasing worldwide,especially for intestinal histotype of the distal third of the stomach.On the contrary,proximal location and diffuse Lauren histotype have been reported to be generally stable over time.In the west,no clear improvement in long-term results was observed in clinical and population-based studies.Results of treatment in these neoplasms are strictly dependent on tumor stage.Adequate surgery and extended lymphadenectomy are associated with good long-term outcome in early-stage cancer; however,results are still unsatisfactory for advanced stages(Ⅲ and Ⅳ),for which additional treatments could provide a survival benefit.This implies a tailored approach to GC.The aim of this review was to summarize the main multimodal treatment options in advanced resectable GC.Perioperative or postoperative treatments,including chemotherapy,chemoradiotherapy,targeted therapies,and hyperthermic intraperitoneal chemotherapy have been reviewed,and the main ongoing and completed trials have been analyzed.An original tailored multimodal approach to non-cardia GC has been also proposed.
