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
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
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: Acute Leukemia is the most common childhood cancer, with two main types: ALL and AML. In Tanzania, recent improvements in treatment and survival have been noted, but the latest data is from 2013. This stud...Background: Acute Leukemia is the most common childhood cancer, with two main types: ALL and AML. In Tanzania, recent improvements in treatment and survival have been noted, but the latest data is from 2013. This study will update survival and relapse information from 2013 to 2020 to help enhance future treatment strategies. Methodology: This study was conducted at two tertiary hospitals in Tanzania. The study analyzed data from children diagnosed with Acute Leukemia between January 2015 to December 2020. Patient data were collected via questionnaires and analyzed using STATA software. Results: This study included a total of 95 participants 64 had age less than 10 years and majority were males 56.8%, 55 had duration of symptoms for more than 1 month 66 had ALL, 49 had attained remission, the overall three years survival was 44.2% with those children with no health insurance having high risk of dying, rate of relapse was 18.4%, with those diagnosed with B-ALL having low risk of relapse. Conclusion: This study provides insights into survival and relapse predictors for childhood leukemia in northern Tanzania. It found an overall survival rate of 44.2%, with health insurance and minimal residual disease after induction being key predictors of survival. The relapse rate was 18.4%, with health insurance linked to a lower relapse risk. Health insurance emerged as a strong predictor of better survival, leading to the recommendation that all children should have health insurance. Additionally, the study suggests that policymakers should support the expansion of global health coverage in Tanzania.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 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 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
Background:Patients with human epidermal growth factor receptor 2(HER2)-positive early breast cancer with residual invasive disease after neoadjuvant systemic therapy have a high risk of recurrence and death.The prima...Background:Patients with human epidermal growth factor receptor 2(HER2)-positive early breast cancer with residual invasive disease after neoadjuvant systemic therapy have a high risk of recurrence and death.The primary analysis of KATHERINE,a phase 3,open-label trial,showed that the risk of invasive breast cancer or death was 50% lower with adjuvant trastuzumab emtansine(T-DM1)than with trastuzumab alone.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
In order to cultivate Manila clam varieties in northern China,we crossed the Dalian wild population(referred to as D)and the Weihai wild population(referred to as W)to create a 2×2 complete diallel hybrid.Ultimat...In order to cultivate Manila clam varieties in northern China,we crossed the Dalian wild population(referred to as D)and the Weihai wild population(referred to as W)to create a 2×2 complete diallel hybrid.Ultimately,we obtained two hybrid groups(D♀×W♂(DW)and W♀×D♂(WD))and two inbred groups(D♀×D♂(DD)and W♀×W♂(WW)).We measured their growth and survival during the larval and juvenile stages and compared the data between hybrid and inbred groups to study the potential heterosis of the hybrid.With the exception of slightly lower values in the WD group,fertilization and hatching rates did not differ significantly among the other groups.However,during the larval stage(days 1–15),we observed significant differences in the growth rate of Manila clam in the hybrid groups at days 1,3,and 6 of age(P<0.05).Among the groups,the clams in the DW group had the highest survival rate,which was indicative of significant heterosis.After entering the juvenile stage(days 30–120),both hybrid groups showed high heterosis in terms of growth and survival.The DW group had the greatest amount of heterosis for survival performance,and the WD group had the greatest amount of heterosis for shell length and height growth.These results indicated that this hybrid combination had great breeding potential,and provided a useful hybrid strategy for producing genetic improvements in R.philippinarum.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 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 Conditional relative survival(CRS),the probability of survival given that an individual has already survived a certain period post-diagnosis,is a more clinically relevant measure for long-term survival than...Background Conditional relative survival(CRS),the probability of survival given that an individual has already survived a certain period post-diagnosis,is a more clinically relevant measure for long-term survival than standard relative survival(RS).This study aims to evaluate the 5-year CRS among adolescent and young adult(AYA)breast cancer patients by age,tumor stage,and receptor subtype to guide disclosure periods for insurance.Methods Data of all females aged 18–39 years and diagnosed with invasive breast cancer between 2003 and 2021(n=13,075)were obtained from The Netherlands Cancer Registry(NCR).The five-year CRS was calculated annually up to 10 years post-diagnosis using a hybrid analysis approach.Results For the total AYA breast cancer study population the 5-year CRS exceeded 90%from diagnosis and increased beyond 95%7 years post-diagnosis.Patients aged 18–24 reached 95%9 years post-diagnosis,those aged 25–29 after 5 years,and those aged 30–34 and 35–39 after 8 years.For stage I,the 5-year CRS reached 95%from diagnosis,for stage II after 6 years,while the 5-year CRS for stages III and IV did not reach the 95%threshold during the 10-year follow-up.Triple-negative tumors exceeded 95%after 4 years,human epidermal growth factor receptor 2(HER2)positive tumors after 6 years,while hormone receptor(HR)positive tumors did not reach 95%.Conclusion Excess mortality among AYA breast cancer patients tends to be little(CRS 90%–95%)from diagnosis and becomes minimal(CRS>95%)over time compared to the general population.These results can enhance expectation management and inform policymakers,suggesting a shorter disclosure period.展开更多
BACKGROUND Rectal cancer is prevalent and associated with substantial morbidity and mortality.AIM To develop a nomogram prediction model for overall survival(OS)in patients with rectal cancer by leveraging a comprehen...BACKGROUND Rectal cancer is prevalent and associated with substantial morbidity and mortality.AIM To develop a nomogram prediction model for overall survival(OS)in patients with rectal cancer by leveraging a comprehensive analysis of demographic,clinicopathological,haematological,and follow-up data to identify independent prognostic factors.METHODS We conducted a prospective cohort study in China involving rectal cancer patients and applied Cox regression and least absolute shrinkage and selection operator regression to assess the significance of various variables as independent prognostic factors for OS.The identified factors were integrated into a nomogram model,which was evaluated for predictive accuracy via the C-index,area under the curve(AUC),calibration curve,and decision curve analysis(DCA).RESULTS Multivariate analysis revealed independent predictors of OS,including the Karnofsky performance status,age,sex,TNM stage,chemotherapy,surgery,targeted therapy,β2-microglobulin,lactate dehydrogenase,and the neutrophil-to-lymphocyte ratio.The nomogram demonstrated a C-index of 0.80 for the training and validation cohorts,with AUC values indicating high predictive accuracy for 1-year,3-year,and 5-year OS.The calibration curves confirmed the model's excellent agreement with the observed survival rates,and DCA revealed the superior clinical utility of the nomogram over the TNM staging system.CONCLUSION In this study,a novel prognostic model that accurately predicts the OS of rectal cancer patients was developed.The model exhibited excellent discriminatory and calibration capabilities,thus offering a reliable tool for health care professionals to estimate patient survival.展开更多
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).
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 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: Acute Leukemia is the most common childhood cancer, with two main types: ALL and AML. In Tanzania, recent improvements in treatment and survival have been noted, but the latest data is from 2013. This study will update survival and relapse information from 2013 to 2020 to help enhance future treatment strategies. Methodology: This study was conducted at two tertiary hospitals in Tanzania. The study analyzed data from children diagnosed with Acute Leukemia between January 2015 to December 2020. Patient data were collected via questionnaires and analyzed using STATA software. Results: This study included a total of 95 participants 64 had age less than 10 years and majority were males 56.8%, 55 had duration of symptoms for more than 1 month 66 had ALL, 49 had attained remission, the overall three years survival was 44.2% with those children with no health insurance having high risk of dying, rate of relapse was 18.4%, with those diagnosed with B-ALL having low risk of relapse. Conclusion: This study provides insights into survival and relapse predictors for childhood leukemia in northern Tanzania. It found an overall survival rate of 44.2%, with health insurance and minimal residual disease after induction being key predictors of survival. The relapse rate was 18.4%, with health insurance linked to a lower relapse risk. Health insurance emerged as a strong predictor of better survival, leading to the recommendation that all children should have health insurance. Additionally, the study suggests that policymakers should support the expansion of global health coverage in Tanzania.
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.
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 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.
文摘Background:Patients with human epidermal growth factor receptor 2(HER2)-positive early breast cancer with residual invasive disease after neoadjuvant systemic therapy have a high risk of recurrence and death.The primary analysis of KATHERINE,a phase 3,open-label trial,showed that the risk of invasive breast cancer or death was 50% lower with adjuvant trastuzumab emtansine(T-DM1)than with trastuzumab alone.
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.
基金sponsored by the the Outstanding Young Scientific and Technological Talents Foundation of Dalian(No.2024RJ014)the Research Project of Liaoning Provincial Department of Education(No.LJ212410158027)+1 种基金the Research Projects of Undergraduate Universities in Liaoning Province(No.2024JBZDZ003)the Liaoning Revitalization Talents Program(No.XLYC2403165).
文摘In order to cultivate Manila clam varieties in northern China,we crossed the Dalian wild population(referred to as D)and the Weihai wild population(referred to as W)to create a 2×2 complete diallel hybrid.Ultimately,we obtained two hybrid groups(D♀×W♂(DW)and W♀×D♂(WD))and two inbred groups(D♀×D♂(DD)and W♀×W♂(WW)).We measured their growth and survival during the larval and juvenile stages and compared the data between hybrid and inbred groups to study the potential heterosis of the hybrid.With the exception of slightly lower values in the WD group,fertilization and hatching rates did not differ significantly among the other groups.However,during the larval stage(days 1–15),we observed significant differences in the growth rate of Manila clam in the hybrid groups at days 1,3,and 6 of age(P<0.05).Among the groups,the clams in the DW group had the highest survival rate,which was indicative of significant heterosis.After entering the juvenile stage(days 30–120),both hybrid groups showed high heterosis in terms of growth and survival.The DW group had the greatest amount of heterosis for survival performance,and the WD group had the greatest amount of heterosis for shell length and height growth.These results indicated that this hybrid combination had great breeding potential,and provided a useful hybrid strategy for producing genetic improvements in R.philippinarum.
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 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.
基金supported by The Netherlands Organization for Scientific Research VIDI(grant number:198.007).
文摘Background Conditional relative survival(CRS),the probability of survival given that an individual has already survived a certain period post-diagnosis,is a more clinically relevant measure for long-term survival than standard relative survival(RS).This study aims to evaluate the 5-year CRS among adolescent and young adult(AYA)breast cancer patients by age,tumor stage,and receptor subtype to guide disclosure periods for insurance.Methods Data of all females aged 18–39 years and diagnosed with invasive breast cancer between 2003 and 2021(n=13,075)were obtained from The Netherlands Cancer Registry(NCR).The five-year CRS was calculated annually up to 10 years post-diagnosis using a hybrid analysis approach.Results For the total AYA breast cancer study population the 5-year CRS exceeded 90%from diagnosis and increased beyond 95%7 years post-diagnosis.Patients aged 18–24 reached 95%9 years post-diagnosis,those aged 25–29 after 5 years,and those aged 30–34 and 35–39 after 8 years.For stage I,the 5-year CRS reached 95%from diagnosis,for stage II after 6 years,while the 5-year CRS for stages III and IV did not reach the 95%threshold during the 10-year follow-up.Triple-negative tumors exceeded 95%after 4 years,human epidermal growth factor receptor 2(HER2)positive tumors after 6 years,while hormone receptor(HR)positive tumors did not reach 95%.Conclusion Excess mortality among AYA breast cancer patients tends to be little(CRS 90%–95%)from diagnosis and becomes minimal(CRS>95%)over time compared to the general population.These results can enhance expectation management and inform policymakers,suggesting a shorter disclosure period.
文摘BACKGROUND Rectal cancer is prevalent and associated with substantial morbidity and mortality.AIM To develop a nomogram prediction model for overall survival(OS)in patients with rectal cancer by leveraging a comprehensive analysis of demographic,clinicopathological,haematological,and follow-up data to identify independent prognostic factors.METHODS We conducted a prospective cohort study in China involving rectal cancer patients and applied Cox regression and least absolute shrinkage and selection operator regression to assess the significance of various variables as independent prognostic factors for OS.The identified factors were integrated into a nomogram model,which was evaluated for predictive accuracy via the C-index,area under the curve(AUC),calibration curve,and decision curve analysis(DCA).RESULTS Multivariate analysis revealed independent predictors of OS,including the Karnofsky performance status,age,sex,TNM stage,chemotherapy,surgery,targeted therapy,β2-microglobulin,lactate dehydrogenase,and the neutrophil-to-lymphocyte ratio.The nomogram demonstrated a C-index of 0.80 for the training and validation cohorts,with AUC values indicating high predictive accuracy for 1-year,3-year,and 5-year OS.The calibration curves confirmed the model's excellent agreement with the observed survival rates,and DCA revealed the superior clinical utility of the nomogram over the TNM staging system.CONCLUSION In this study,a novel prognostic model that accurately predicts the OS of rectal cancer patients was developed.The model exhibited excellent discriminatory and calibration capabilities,thus offering a reliable tool for health care professionals to estimate patient survival.
