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ABSTRACT: BACKGROUND: According to the Lauren classification, gastric adenocarcinomas are divided into diffuse and intestinal types. The causative attribution explaining the dismal prognosis of diffuse-type remains unknown. METHODS: We examined the archive of 1000 patients with gastric adenocarcinomas who received radical gastrectomy in our center and assessed the effect of the Lauren classification on survival in a multivariate approach. Moreover we compared the variation of clinical features between the diffuse-type and intestinal-type and explored the contributing factors for the prognostic difference. RESULTS: There were 805 resectable patients for the final analysis. Diffuse-type comprised of 48.7% in the gastric carcinoma in our group and showed poorer prognosis than intestinal-type (P=0.013). Multivariate analysis revealed that independent prognostic factors for gastric carcinoma patients were T stage (P<0.001), N stage (P<0.001) tumor size (P<0.001) and Lauren classification (P=0.003). For the clinical features, diffuse-type was significantly associated with younger age (p<0.001), female preponderance (p <0.001), distal location (P<0.001), advanced pT (p < 0.001), advanced pN (p < 0.001) and advanced TNM stage (p = 0.027) . CONCLUSIONS: Diffuse type adenocarcinoma carries a worse prognosis that may be partially explained by the tendency of this subtype to present at more advanced T and N stage. However, Lauren classification has prognostic significance that is independent of T and N stage as well as other prognostic variables based on the multivariate cox analysis.
Journal of Translational Medicine 03/2013; 11(1):58. · 3.41 Impact Factor
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Ying Jin,
Miao-Zhen Qiu,
De-Shen Wang, Dong-Sheng Zhang,
Chao Ren,
Long Bai,
Hui-Yan Luo,
Zhi-Qiang Wang,
Feng-Hua Wang,
Yu-Hong Li,
Rui-Hua Xu
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ABSTRACT: A phase III clinical trial has already shown the survival benefits of postoperative chemotherapy in gastric cancer. However, there are limited published data concerning the elderly. This study aims to investigate the use of adjuvant chemotherapy for gastric cancer after D2 gastrectomy among the elderly and identify its impact on survival.
We retrospectively reviewed 360 patients who had undergone D2 gastrectomy, aged 65 years or older, with non-metastatic gastric cancer in a single institution. We analyzed the predictors and survival benefits of adjuvant chemotherapy use in the elderly. Further, we analyzed the survival benefits of adjuvant chemotherapy by dividing the patients into groups according to disease stages and chemotherapeutic regimens.
Among the 360 patients, only 34.7% of patients received adjuvant chemotherapy. Age, tumor location, lymph node involvement and tumor invasion were associated with the receipt of adjuvant chemotherapy. Adjuvant chemotherapy improved the overall survival for non-metastatic elderly patients (HR 0.60, 95%CI 0.42-0.83, P = 0.003). Significant survival benefits were found with adjuvant chemotherapy in stage III patients (HR 0.67, 95%CI 0.47-0.97, P = 0.033), but not in stage I patients or in stage II patients (HR 0.52, 95%CI 0.21-1.30 P = 0.161). Compared to adjuvant chemotherapy without platinum, no significant survival benefits were observed with platinum-containing chemotherapy (HR 0.84, 95%CI 0.49-1.45, P = 0.530). Besides adjuvant chemotherapy, other independent prognostic factors of survival included tumor location, tumor size, histologic grade, depth of tumor invasion, and lymph node status.
This study demonstrated the survival benefits of adjuvant fluoropyrimidine-based chemotherapy among the elderly patients with non-metastatic gastric cancer after D2 gastrectomy. However, due to the limitations of this study, further well-designed prospective studies with large populations are needed to confirm these findings and identify the patients that can tolerate and benefit from adjuvant chemotherapy.
PLoS ONE 01/2013; 8(1):e53149. · 4.09 Impact Factor
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ABSTRACT: The aim of the present study was to determine whether C-reactive protein (CRP)-based systemic inflammatory response scores (modified Glasgow prognostic score, mGPS; prognostic index, PI) have prognostic value superior to that of scores based on circulating white cells (neutrophil/lymphocyte ratio, NLR; platelet/lymphocyte ratio, PLR) or in combination with albumin (prognostic nutritional index, PNI) in patients with pancreatic cancer. The medical records of 177 patients with pancreatic adenocarcinoma were reviewed. Kaplan-Meier methodology and a multivariable Cox proportional hazards model were used to evaluate the potential prognostic factors. NLR > 5 was associated with higher white cell count, higher PLR, elevated CRP, hypoalbuminemia, increased mGPS, PI and PNI, poorer performance status (PS), greater weight loss and poorer tumor differentiation. On multivariate analysis, only NLR (HR, 2.537; 95 % CI, 1.313-4.902; p = 0.006), PS, tumor-node-metastasis (TNM) staging, type of surgery and palliative chemotherapy were associated independently with survival, whereas PLR, mGPS, PI and PNI were not. NLR > 5 predicted poorer overall survival (OS) compared with NLR ≤ 5 (median OS, 4.133 and 9.300, respectively; p = 0.006). On the subgroup analysis, the median OS of patients with NLR > 5 was 5.767 months, whereas patients with NLR ≤ 5 who had received palliative chemotherapy had a median OS of 10.200 months (p < 0.001). Our study demonstrates that elevated NLR is superior to the mGPS, PI, PLR and PNI for prognostication in patients with pancreatic cancer.
Medical Oncology 04/2012; · 2.14 Impact Factor
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ABSTRACT: The development of pancreatic cancer is a process in which genes interact with environmental factors. We performed this study to determine the effects of the ABO blood group, obesity, diabetes mellitus, metabolic syndrome (MetS), smoking, alcohol consumption and hepatitis B viral (HBV) infection on patient survival.
A total of 488 patients with pancreatic cancer were evaluated.
Patients who presented as chronic carriers of HBV infection were younger at disease onset (p = 0.001) and more predominantly male (p = 0.020) than those never exposed to HBV. Patients with MetS had later disease staging (p = 0.000) and a lower degree of pathological differentiation (p = 0.008) than those without MetS. In a univariate analysis, the ABO blood group, smoking and alcohol consumption were not associated with overall survival. HBsAg-positivity and elevated fasting plasma glucose were significantly associated with unfavorable survival though not in the multivariate analysis. The presence of MetS (HR: 1.541, 95% CI: 1.095-2.169, p = 0.013), age ≥65, an elevated CA19-9 baseline level, TNM staging, the type of surgery, the degree of differentiation and chemotherapy were independently associated with overall survival.
We report, for the first time, that patients with chronic HBV infection may represent a special subtype of pancreatic cancer, who have a younger age of disease onset and male dominancy. Patients with MetS had later disease staging and a poorer histological grade. Patients with MetS demonstrated significantly poorer survival.
PLoS ONE 01/2012; 7(7):e41984. · 4.09 Impact Factor
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ABSTRACT: The aim of present study was to examine whether the C-reactive protein (CRP)-based systemic inflammatory response such as the Glasgow Prognostic Score (GPS; a combination of CRP and albumin) offers prognostic value that is superior to the circulating white cellular components as neutrophil/lymphocyte ratio (NLR) or platelet/lymphocyte ratio (PLR) in patients undergoing resection for stage III gastric cancer. The medical records of 324 patients with stage III gastric adenocarcinoma were reviewed. Potential prognosis factors were evaluated with the Kaplan-Meier methodology and multivariable Cox hazards model. An increase of GPS was associated with an increase weight loss, higher NLR, higher PLR, and larger tumor size. On multivariate analysis, only the GPS, tumor-nodes-metastasis staging, and adjuvant chemotherapy were associated independently with disease-free and overall survival. However, the NLR and PLR were not. In subgroup analysis, patients with a GPS of 2 had a significantly poorer median survival (13.70 months) when compared with patients with a GPS of 1 (27.4 months) or 0 (median survival had not been reached) in patients who had received adjuvant chemotherapy. Our study demonstrated that elevated preoperative GPS is superior to circulating white cellular components and was associated with reduced overall and disease-free survival for patients with stage III gastric cancer.
Tumor Biology 12/2011; 33(3):749-56. · 1.94 Impact Factor
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ABSTRACT: Little is known about the role of association between ABO blood type and risk of pancreatic cancer develops through effects on hepatitis B viral (HBV) infection. Our study aimed to determine whether joint ABO blood type and HBV infection could increase the risk for pancreatic cancer. A total of 645 patients with pancreatic adenocarcinoma and 711 age- and sex-matched individuals who had nonmalignant diseases treated at the Sun Yat-sen University Cancer Center in China were retrospectively analyzed. Blood samples were tested for ABO blood type and hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), hepatitis B e antibody (anti-HBe) and hepatitis B core antibody (anti-HBc). Multivariable unconditional logistic regression analysis was used to estimate adjusted odds ratios [AORs] and 95% confidence interval [CI]. Multivariable analysis with adjustment for risk factors showed that A blood type, HBsAg-positive/anti-HBc-positive, anti-HBs-positive/anti-HBc-positive were significantly associated with pancreatic cancer. The estimated AORs (95% CI) were as follows: A blood type, 1.425 (1.071-1.894), HBsAg-positive/anti-HBc-positive, 1.610 (1.125-2.304), anti-HBs-positive/anti-HBc-positive, 1.526 (1.159-2.011). The effect of A blood type significantly modified the risk of pancreatic cancer among subjects with anti-HBc-positive (AORs = 1.882, 95% CI, 1.284-2.760). In our study, we reported an association between A blood type, infection with HBV and pancreatic cancer risk. Moreover, we found a synergism between A blood type and HBV infection in the development of pancreatic cancer.
International Journal of Cancer 08/2011; 131(2):461-8. · 5.44 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the clinical characteristics and survival outcomes of patients with primary mediastinal germ cell tumor (PMGCT) by identifying the prognostic factors and efficacies of different treatment modalities.
Fifty-five patients with PMGCT who were treated consecutively at Cancer Center, Sun Yat-sen University, Guangzhou, from 1988 to 2010 were evaluated retrospectively.
Fifty-two men and 3 women with a median age of 25 years were identified, of whom 17 (30.9%) had pure seminomatous, 38 (69.1%) had nonseminomatous histology, 27 (49.1%) had tumor located at mediastinum, 20 (36.4%) had lung metastases and/or effusions, and 8 (14.5%) had distant metastases. Three treatments surgery, chemotherapy, and radiotherapy were performed in 11 (20%) patients, two treatments chemotherapy plus surgery or radiotherapy were performed in 25 (45.6%), and single treatment surgery or chemotherapy was performed in 17 (30.9%). The other two patients (3.6%) received no treatment. After a median follow-up time of 31.4 months, the 5-year survival rate was 52%. The median overall survival time was 87.9 months. Patients who received two treatments had the longest survival time of 118.3 months, P = 0.000. Those who had pure seminoma histology, whose tumor confined to the mediastinum and who achieved complete or partial remission at initial evaluation, who had complete resection and radiotherapy were considered to have better prognosis according to univariate analysis. On multivariate analysis, extension and response rate at initial evaluation were independently predictive of survival.
Primary mediastinal germ cell tumor is rare with a dominant frequency in young male patients. Chemotherapy combined with local therapy like surgery or radiotherapy is a reasonable treatment strategy recommended. Extension and initial remission rate are independent prognostic factors.
Journal of Cancer Research and Clinical Oncology 08/2011; 137(11):1607-12. · 2.56 Impact Factor
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ABSTRACT: Pancreatic neuroendocrine tumors (PNETs) are uncommon malignancies. The purpose of this study was to identify the prognostic factors of pancreatic neuroendocrine tumors at a single center in China. Clinical data of 27 patients with PNETs treated at the Sun Yat-sen University Cancer Center between January 1995 and December 2010 were retrospectively reviewed. Survival was estimated with the Kaplan-Meier methodology. Twenty-three patients (85.2%) had nonfunctional tumors and four patients (14.8%) had functional tumors. The majority of PNETs located in the body and/or tail of the pancreas in 20 patients (74.1%). All Patients with functional tumors cause syndromes related to hormone overproduction. Anorexia, nausea, vomiting, obstructive jaundice, weight loss, and incidental mass were more common in patients with nonfunctional tumors. The median follow-up time was 40 months. The overall 1-, 2-, and 5-year accumulative survival rates were 91%, 81%, and 81%, respectively. In univariate analysis, factors associating with significantly better survival included macroscopically radical resection of the primary tumor, tumor-node-metastasis (TNM) staging, World Health Organization (WHO) classification, and palliative chemotherapy. Macroscopically radical resection of the primary tumor, TNM staging, WHO classification, and palliative chemotherapy were prognostic variables which may emerge as a practical clinical tool to predict survival.
Tumor Biology 04/2011; 32(4):697-705. · 1.94 Impact Factor
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ABSTRACT: The 7th edition of American Joint Committee on Cancer tumor-node-metastasis (AJCC TNM) staging system was put into use recently. The study aimed to evaluate its predictive ability on survival and compare the difference between the 6th and 7th editions of AJCC TNM system in gastric carcinoma.
A total of 1000 gastric carcinoma patients receiving treatment in our center were selected for the analysis. Patients were staged using both the 6th and 7th editions AJCC TNM staging system. Survival analysis was performed with a Cox regression model.
Of previous stage IV patients, 39.9% (112 of 281) migrated to a lower tier in the 7th edition. By setting the cutoff of positive lymph nodes as 0, 2, 6, and 15, the 7th edition strengthens the role of positive lymph nodes. Multivariable regression analysis showed that both 6th and 7th TNM stage systems were independent factors for overall survival. For lymph nodes negative patients, the 5-year overall survival for patients with fewer than 15 resected lymph nodes was significantly lower than those with more than 15.
AJCC 7th is not superior to AJCC 6th in predicting the 5-year overall survival rates of gastric adenocarcinoma patients. The definition of stage IV and the selection of cutoffs for MLNC in the AJCC 7th system is much more reasonable compared with the AJCC 6th system.
Annals of Surgical Oncology 01/2011; 18(7):1869-76. · 4.17 Impact Factor
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ABSTRACT: The incidence of gastric cancer in young has increased steadily in the last decades. Little is known about the clinicopathologic features and prognostic factors of young adult gastric cancer patients. The clinicopathological characteristics of 294 young adult gastric cancer patients between 20 and 50 years old were reviewed retrospectively from hospital records in Sun Yat-Sen University Cancer Center between 1996 and 2006. They were compared with 706 elder patients 51 years of age or over. A steady increasing in the proportion of female in the gastric carcinoma patients as the age decreasing was found. The distinguishing histological features of young adult patients were higher percentage of poorly differentiated grade and distant metastasis. The distribution of tumor-nodes-metastasis (TNM) stage was similar between these two groups. The 5-year disease-specific survival rate in the young adult group was significantly higher than in the elderly group. More patients receiving adjuvant chemotherapy were found in the young adult group. Multivariable analysis demonstrated that TNM stage and presence of angiolymphatic invasion were the independent negative predictors of survival for young patients with gastric cancer. Gastric cancer in young patients differs from that in elderly patients including a lack of male predilection, more aggressive histologic features, and better survival rate.
Tumor Biology 12/2010; 32(3):509-14. · 1.94 Impact Factor
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ABSTRACT: Gastric cancer patients with negative nodes were considered to have better outcomes, however, some of them still suffered from disease recurrences or distant metastases after radical resection. A total of 1,020 gastric carcinoma patients receiving treatment in our center between 2003 and 2008 were selected for the analysis. All patients received gastrectomy and D2 lymphadenectomy. Survival analysis was performed with Cox regression model. The final study includes 222 patients. The overall 5-year disease-specific survival rate was 73.0%. Factors bearing significant association with lower survival on univariate analysis included the age of 58 years old or more (P = 0.021), tumor size longer than 4 cm (P < 0.001), presence of angiolymphatic invasion (P = 0.006), proximal site (P = 0.030), serosal invasion (T3+T4, P = 0.003), and higher TNM stage (P < 0.001). Only three factors including serosal invasion, tumor size at least 4.0 cm, and presence of angiolymphatic invasion remained independent negative predictors of survival in multivariable analysis. These parameters can be employed to select node-negative gastric cancer patients for an adjuvant setting and close follow-up scheduling.
Tumor Biology 12/2010; 32(3):489-92. · 1.94 Impact Factor
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ABSTRACT: Little is known about the relationship between ABO blood groups and the clinicopathologic features in gastric adenocarcinoma patients of China. Whether the distribution of ABO blood groups in patients with gastric adenocarcinoma differs from that with benign diseases is also unknown. A total of 474 gastric adenocarcinoma patients and 404 with benign diseases were enrolled for the study. The relationship between patients' ABO blood groups and the clinicopathologic features was analyzed. The percentage of blood group AB was more common in men of gastric cancer than in benign diseases. The proportion of angiolymphatic invasion among patients with blood group O was significantly lower than those with other blood groups (P = 0.034). Proportion of tumors associated with estrogen receptor (ER), progestogen receptor (PR) and carcinoembryonic antigen (CEA) expression in blood type A was significantly higher than in other blood types (P = 0.002 for ER expression, 0.009 for PR expression, 0.003 for CEA expression). Proportion of tumors associated with serum CEA and CA19-9 elevation in blood type AB was significantly lower than in other blood types (P < 0.001 for serum CEA elevation, 0.005 for CA19-9 elevation). Though there was no significant difference between ABO blood groups and survival of the patients, patients with blood group B had a trend to show superiority in the survival. The significance of ABO blood group distribution might be associated with biological behavior of gastric adenocarcinoma patients. However, it was found not to be a prognosis factor for patients with gastric adenocarcinoma.
Medical Oncology 11/2010; 28 Suppl 1:S268-73. · 2.14 Impact Factor
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ABSTRACT: Irinotecan (CPT-11), oxaliplatin, 5-fluorouracil (5-FU) and capecitabine are main active agents for advanced colorectal cancer. FORFIRI regimen is recommended for the patients who were treated with oxaliplatin plus 5-FU or capecitabine previously. This study was to investigate the efficacy and safety of FORFIRI regimen in treating advanced colorectal cancer failing to prior oxaliplatin-based chemotherapy, and analyze the impacts of clinical factors on the responses.
A total of 90 patients with advanced colorectal adenocarcinoma, who had received prior adjuvant FOLFOX6 regimen and progressed within 12 months after the completion of therapy or had no response to prior FOLFOX6/CapeOX regimen as first-line therapy, were treated with FORFIRI regimen. The efficacy and adverse events were observed.
Of the 81 evaluable patients, two achieved complete remission, 20 achieved partial remission and 34 had stable disease. The overall response rate was 27.2% and disease control rate was 69.1%. The median time to progression was 6.8 months (95% CI, 4.9-8.8 months) and median overall survival time was 18.8 months (95% CI, 17.5-20.2 months). The main adverse events time were nausea, vomiting, neutropenia, alopecia, fatigue, impaired liver function, oral mucositis and diarrhea. Grade III adverse events included alopecia in 15 patients (16.7%), vomiting in 10 patients (11.1%), nausea in eight patients (8.9%), neutropenia in five patients (5.6%), impaired liver function in two patients (2.2%) and oral mucositis in two patients (2.2%).
FOLFIRI regimen is effective and well-tolerated as salvage therapy for advanced colorectal cancer failing to prior FOLFOX6/CapeOX regimen, and thus can be used widely.
Ai zheng = Aizheng = Chinese journal of cancer 10/2009; 28(9):913-8.
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ABSTRACT: Recently, some phase I trials on endostatin has shown broad antitumor activity with low toxicity. This study was to determine the maximal tolerant dose (MTD) of recombinant human endostatin adenovirus Ad-Es for human.
For the sake of safety, 1 patient was treated with 1x10(10) VP Ad-Es single intratumoral injection in advance. A total of 14 patients with malignant tumors received weekly intratumoral injection of Ad-Es in a dose-escalation manner (1x10(11) VP, 5x10(11) VP, 1x10(12) VP) for 2 weeks.
Toxicity profiles in all 15 cases were available. All patients tolerated well. No dose-limited toxicity (DLT) and serious adverse event were observed during treatment. Main adverse events were injection reaction (40.0%) and fever (53.3%). One patient with nasopharyngeal carcinoma had a minor response, 12 patients showed stable disease and 2 patients had progressive disease.
Ad-Es is well tolerated up to 1x10(12) VP. The recommended dose for phase II trial is 1x10(12) VP intratumor injection for 4 consecutive weeks.
Ai zheng = Aizheng = Chinese journal of cancer 08/2007; 26(8):856-60.
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ABSTRACT: Primary paranasal sinus lymphoma (PPSL) is a rare presentation of extranodal non-Hodgkin's lymphoma with a natural history distinct from other lymphomas. This study was to evaluate the clinical and pathologic characteristics, treatment outcomes and prognosis of PPSL.
The records of 14 PPSL patients, treated at Cancer Center of Sun Yat-sen University from 1994 to 2006, were analyzed.
The primary involvement sites included the maxillary sinus (11 cases), ethmoid sinus (2 cases), and sphenoid sinus (1 case). All patients were at stage I-II (Ann Arbor system). According to the AJCC TNM staging system, most patients had advanced T3-T4 disease. Of the 14 patients, 12 had B-cell PPSL, 1 had T-cell PPSL, and 1 had unclassified PPSL. The most common type was diffuse large B-cell PPSL (6 cases, 42.9%). Two patients underwent total maxillectomy and 12 underwent local excision or biopsy. All patients received chemotherapy and 6 received radiotherapy after chemotherapy. Both 5-year overall and event-free survival rates were 78.6%, with a median survival of 59.5 months(range, 2-192 months).
PPSL is an uncommon presentation of lymphoma characterized by bulky local disease. Diffuse large B-cell lymphoma is the most common histologic type and the maxillary sinus is the most common original site of PPSL. A combined-modality approach with systemic chemotherapy and local-regional radiation is recommended for PPSL patients. The prognosis of PPSL is relatively good.
Ai zheng = Aizheng = Chinese journal of cancer 08/2007; 26(8):919-22.
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ABSTRACT: Few treatment options are available for metastatic breast cancer with resistance to both anthracycline-and taxane-based chemotherapy regimens. Docetaxel combined capecitabine (DC regimen) is approved as a new active regimen for metastatic breast cancer. This study was to explore the efficacy of DC regimen on metastatic breast cancer, and evaluate its safety.
A total of 31 metastatic breast cancer patients received DC regimen during each 3-week chemotherapy cycle. All patients received oral administration of capecitabine (1250 mg/m(2)) twice daily, within 30 min after meal on day 1 to Day 14, and infusion of docetaxel (75 mg/m(2)) on the first day of each 3-week cycle. All patients received prophylactic therapy with oral dexamethasone (8 mg) twice daily on 3 successive days.
A total of 116 cycles of DC regimen were administered, with a median of 3.7 cycles. The objective response rate was 41.9%, with a complete remission (CR) rate of 9.6%. The most frequent treatment-related adverse events were fatigue, leukopenia, nausea, vomiting, hand-foot syndrome, and stomatitis. The median follow-up was 10.8 months (range 2-23 months). Two patients were died of tumor progression.
The combination of docetaxel and capecitabine provides a well-tolerated and active chemotherapy regimen for metastatic breast cancer.
Ai zheng = Aizheng = Chinese journal of cancer 04/2007; 26(4):407-10.
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ABSTRACT: The prognosis of breast cancer patients with liver metastasis is poor. How to improve treatment efficacy and prolong survival of these patients is a challenge in clinic. This study was to explore the efficacy of chemotherapy and transcatheter arterial chemoembolization (TACE) on breast cancer patients with liver metastasis, and analyze prognostic factors.
Clinical data of 98 breast cancer patients with liver metastasis, treated from 1996 to 2005 in Cancer Center of Sun Yat-sen University, were analyzed retrospectively. The prognostic factors correlated to clinical features and treatment approaches were determined using Cox multivariate model.
The total response rate was 45.9% for all patients, 48.6% for the 74 patients received systemic chemotherapy, 23.1% for the 13 patients received TACE, and 54.6% for the 11 patients received chemotherapy plus TACE. At a median follow-up of 17 months (3-56 months), the 1-, 2-, 3-, and 4-year survival rates were 36%, 19%, 13%, and 3%, respectively; the median survival was 17 months (3-56 months), and the progression-free survival was 6 months (0-50 months).
The combination of systemic chemotherapy and TACE may prolong the survival of breast cancer patients with liver metastasis.
Ai zheng = Aizheng = Chinese journal of cancer 04/2007; 26(4):423-6.
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ABSTRACT: Colorectal cancer is one of the most common malignant tumors in China. Synchronous liver metastases occur in 10%-25% colorectal cancer patients. This study was to elucidate the prognostic factors and treatment choices for colorectal cancer patients with synchronous liver metastases.
Records of 220 colorectal cancer patients with synchronous liver metastases initially treated at Cancer Center of Sun Yat-sen University from Dec. 1995 to Dec. 2002 were reviewed. Prognostic factors were analyzed by Kaplan-Meier method and Cox regression model with SPSS12.0 software.
The 5-year overall survival rate was 5.52%, the median survival time of the patients was 12.93 months. Univariate analysis of clinical characteristics revealed that the number, size and distribution of liver metastases, extrahepatic disease, serum CEA level at diagnosis, N status, and histology were prognostic factors. Univariate analysis of clinical treatment factors showed that treatment modality, primary site resection, and chemotherapy regimen were prognostic factors. Multivariate analysis showed that the number and size of liver metastases, extrahepatic disease, serum CEA value at diagnosis, treatment modality, primary tumor resection, and chemotherapy regimen were independent prognostic factors of colorectal cancer patients with synchronous liver metastases.
Liver metastases larger than 5 cm in diameter, bilobar liver metastases, extrahepatic invasion or metastases, and CEA level more than 200 microg/L at diagnosis are adverse prognostic factors. Primary tumor resection and liver resection should be considered for all suitable patients with colorectal metastases to the liver alone. Liver-target intervention and/or systemic chemotherapy might be a good choice for inoperable patients. If possible, systemic chemotherapy containing oxaliplatin is preferred.
Ai zheng = Aizheng = Chinese journal of cancer 09/2006; 25(9):1153-7.
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ABSTRACT: 90K, a kind of secretory glycoprotein, is related to prognosis of some tumors. So far, little is reported on its relation to prognosis of non-Hodgkin's lymphoma (NHL). This study was to explore the 90K expression in naive NHL tissues and its clinical significance.
90K expression in 110 specimens of NHL was detected by immunohistochemistryû its correlations to short-term treatment efficacy of CHOP regimen and long-term survival of the patients were analyzed retrospectively.
Of the 110 NHL specimens, 36 (32.7%) showed negative expression of 90K, 27 (24.5%) showed weak expression, 17 (15.5%) showed fairly strong expression, and 30 (27.3%) showed strong expression; the positive rate of 90K in NHL tissue was 67.3%. 90K expression had no correlation to gender, age, IPI and other clinicopathologic characteristics. All patients received treatment of standard CHOP regimen; the response (complete remission and partial remission) rate was significantly higher in low 90K expression (negative and weak expression) group than in high 90K expression (fairly strong and strong expression) group [82.5% (52/63) vs. 65.2% (30/46), P=0.039], but 90K expression had no correlation to long-term survival (P > 0.05).
90K expression may be applied to predict short-term efficacy of CHOP regimen on NHL. However, whether 90K could become a prognostic tumor marker of NHL needs further research.
Ai zheng = Aizheng = Chinese journal of cancer 08/2005; 24(8):1006-10.
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ABSTRACT: For newly diagnosed non-Hodgkin's lymphoma (NHL), CHOP regimen shows good response, but quite a few patients belong to intrinsic drug resistance, or relapse after complete remission (CR). Clinical study has been focused on screening them out and improving the therapeutic response. The purpose of this study was to explore the predictive value of serum 90K/Mac-2BP on chemotherapy response in newly diagnosed NHLs, and to analyze the potential significance of serum 90K/Mac-2BP as a tumor marker in NHLs.
Thirty healthy donors and 100 newly diagnosed patients were included in this study. Serum 90K/Mac-2BP level was measured with the quantitative sandwich enzyme linked immunosorbent assay (ELISA), and the relationship between serum 90K/Mac-2BP level and the therapeutic response as well as clinicopathological features was analyzed.
The level of serum 90K/Mac-2BP was associated with the response of the initial treatment in patients who received CHOP (CTX, ADM, VCR, Pred) chemotherapy. The response rate in patients with higher level (mean serum level >13.62 microg/ml) of 90K/Mac-2BP was 47.6% (20/42). The response rate in patients with lower level (mean serum level <or=13.62 microg/ml) reached 93.6% (44/47) (P< 0.001). The level of serum 90K/Mac-2BP was not relevant to age, gender, pathologic classification, performance status, Ann Arbor stage, international prognostic index(IPI),serum level of lactate dehydrogenase(LDH), bone marrow involvement, and bulky disease (P >0.05).
The level of serum 90K/Mac-2BP might predict the response of CHOP chemotherapy in NHLs, and is hopeful to be a new tumor marker.
Ai zheng = Aizheng = Chinese journal of cancer 08/2003; 22(8):870-3.
