Jianhua Fu

State Key Laboratory of Medical Genetics of China, Ch’ang-sha-shih, Hunan, China

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Publications (19)29.35 Total impact

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    ABSTRACT: Backgroud and objectivesHealth-related quality of life (HRQL) is of great importance in cancer management. The aim was to identify factors that influence postoperative HRQL in esophageal carcinoma patients.MethodsA prospective cohort study was conducted to enroll 196 patients with esophageal carcinoma from November 2012 to June 2013. Sociademographic and clinicopathological parameters were recorded in detail. EORTC-QLQ C30 and ES18 were used to assess HRQL before surgery, at discharge, 1 and 6 months after discharge. Logistic regression models were used to identify factors independently influencing quality of life at 6 months after discharge.ResultsHRQL dramatically decreased after esophagectomy, but restored within 6 months in the most scales. Multivariate logistic regression analysis showed that gender (P = 0.002) and anastomotic stricture (P = 0.001) were the independent predictors of poor global quality-of-life 6 months after discharge. Anastomotic stricture occurred in 22 patients (11.2%), and their performance in social function (P = 0.04), problems with eating (P = 0.006), choking when swallowing (P < 0.001) were significantly poorer at 6 months after discharge. There were not significant differences in global quality-of-life between patients with and without anastomotic leakage at three postoperative assessments.Conclusions Postoperative HRQL is restored within 6 months after discharge. Occurrence of anastomotic stricture significantly decreases HRQL after esophagectomy. J. Surg. Oncol. © 2014 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 11/2014; · 2.64 Impact Factor
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    ABSTRACT: Alcohol is a well-established cause of esophageal carcinoma, but its effect on survival is little known and contradictory. To clarify whether drinking is an independent predictor of survival in esophageal carcinoma, 2151 Chinese patients, receiving surgical resection from January 1997 to December 2008, were followed until March 2014. Cox proportional hazards analysis was applied to evaluate the prognostic effect of alcohol consumption. The median follow-up was 64 months. The median overall survival (42 months) and disease-free survival (33 months) for never-drinkers were significantly higher than ever-drinkers (27 and 22 months, respectively). In the multivariate Cox model that was adjusted for age, weight loss, AJCC stage, radicality of surgery, adjuvant treatment, smoking status and gender, the HRs of ever-drinking were 1.22(1.06-1.41, p=0.005) on overall survival, and 1.16(1.01-1.34, p=0.037) on disease-free survival. The hazardous effect on overall and disease-free survival of drinking grew statistically significantly in a dose-dependent manner with increasing amount of alcohol consumption per day (both p value for trend <0.05). The predictive effect of drinking on overall survival (p=0.596) or disease-free survival (p=0.207) was not significant in the subgroup with esophageal adenocarcinoma (n=195). The current study revealed that the survival is shortened, of those patients who consume alcohol before diagnosis of esophageal squamous cell carcinoma, which are not attributable to differences in stage, smoking status and gender. Alcohol control should be emphasized to reduce mortality of esophageal carcinoma, and further outcome studies should include alcohol as potential prognosticator.This article is protected by copyright. All rights reserved.
    Cancer Science 10/2014; · 3.48 Impact Factor
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    ABSTRACT: Pulmonary sarcomatoid carcinoma (PSC) is a rare malignancy.
    American journal of clinical oncology. 07/2014;
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    ABSTRACT: Background Primary lymphoepithelioma-like carcinoma (LELC) of the lung is uncommon in non-small cell lung cancer (NSCLC). Epidermal growth factor receptor (EGFR) targeted therapy has been applied in advanced common NSCLC. Whether EGFR-targeted therapy is also suitable for LELC of the lung remains unclear. As we know, EGFR gene mutation is a predictive factor. Therefore, EGFR gene mutations in exons 19 and 21 in Chinese patients with LELC of the lung were investigated. Methods Clinicopathological information was obtained by a retrospective review of the medical history recorded in the patients' charts. EGFR gene mutations in exons 19 and 21 were analyzed in 32 samples of LELC of the lung by TaqMan real-time polymerase chain reaction (RT-PCR). ResultsEleven (34.4%) of the patients were male and 21 (65.6%) patients female. The mean age at diagnosis was 50.9 years (range, 25–71 years). Seven (21.9%) of the patients were smokers. In situ hybridization for Epstein-Barr virus-encoded small RNAs (EBERs) showed positive signals in all 32 patients. None of the tumors had mutations in exons 19 and 21. EGFR-targeted therapy was used in three patients with advanced disease and one patient with distant recurrence. However, no obvious therapeutic effect was found. Conclusion These data showed that LELC of the lung, a special histological type of lung cancer, lacked EGFR gene mutations in exons 19 and 21, which suggested that there was no opportunity for EGFR-targeted therapy for patients with LELC of the lung.
    Thoracic Cancer. 01/2014; 5(1).
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    ABSTRACT: To evaluate the feasibility and safety of recurrent laryngeal nerve (RLN) lymph node (LN) dissection, this study compared the postoperative complications and survival between modern two-field lymphadenectomy (MTL) and modified standard two-field lymphadenectomy (MSTL) by using the propensity score matching method. After generating propensity scores given the covariates of age, sex, tumor length, tumor location, tumor grade, and clinical stage, 254 patients with MTL were matched to 254 MSTL patients using the nearest available score matching. The LNs resected during MSTL were paraesophageal and preparatracheal LNs in the upper mediastinum, in addition to those resected during standard two-field lymphadenectomy. RLN LNs were those most commonly affected by nodal metastasis in our series (26 %). Metastasis in RLN LNs was found in around 35, 25, and 20 % of patients with cancer in the upper, middle, and lower thoracic esophagus, respectively. LN metastasis was confined to the RLN region in 49 patients. Even 35 % of patients with pT1 tumors had positive RLN LNs. MTL increased the mean number of resected LNs when compared to MSTL (29 vs.15; p < 0.001). Recurrence was more frequent in those assigned MSTL than those assigned MTL (p < 0.001). The 5-year overall survival (OS) and disease-free survival (DFS) rate for MTL were 50.7 and 42 % compared to 35.3 and 28.2 % for MSTL (both p < 0.001), respectively. Postoperative complications were more frequent following MTL when compared to the MSTL. However, no statistically significant difference in postoperative complications was observed between the two groups. Adding the removal of RLN LNs might improve OS and DFS with acceptable morbidity for patients with ESCC.
    Journal of Gastrointestinal Surgery 11/2013; · 2.36 Impact Factor
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    ABSTRACT: Background The purpose of this study is to investigate the ability of the 7th edition of the American Joint Committee on Cancer tumor-nodes-metastasis (AJCC/TNM) staging system to distinguish between patients at higher risk and to predict the overall survival in patients who underwent surgical resection for esophageal squamous cell carcinoma (ESCC). Methods Between 1998 and 2008, 560 patients with ESCC underwent R0 tri-incisional esophagectomy at our center without neoadjuvant or adjuvant therapy. We performed univariate and multivariate analyses to identify prognostic factors for survival. ResultsThe five-year overall survival rate was 44.1%, with a median survival of 44 months. Gender, pT status, pN status, and the retrieved lymph nodes (LNs) category (<15 vs. ≥15) were found to be significant prognostic factors, whereas histology grade and tumor location were not significant prognostic factors in our analysis. When classified as all eight sub-stages, there were similar survival curves between stages IB and IIA (P = 0.799), and stages IIIC and IV (P = 0.635). Multivariate Cox proportional hazard regression analysis indicated that gender, pT category, pN category, and the retrieved LNs category (<15 vs. ≥15) were significantly associated with patient survival. Conclusion The 7th edition AJCC staging system proposed a new descriptor for “N” classification. Further stratification of pN status according to number of positive LNs in the 7th edition is valuable. However, we did not find tumor location and histology grade were significant prognostic factors. Moreover, adding a substantially higher threshold of LNs retrieved in the next revision of the AJCC/TNM staging system for ESCC may be more valuable.
    Thoracic Cancer. 11/2013; 4(4).
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    ABSTRACT: To assess the therapeutic outcome and failure pattern of three-dimensional conformal radiotherapy (3D-CRT)-based concurrent chemoradiotherapy (CCRT) for recurrence of esophageal squamous cell carcinoma (SCC) after radical surgery. Treatment outcome and failure pattern were retrospectively evaluated in 83 patients with localized cervical and thoracic recurrences after radical surgery for thoracic esophageal SCC. All patients were treated with 3DCRT-based CCRT (median radiation dose 60Gy), in which 39 received concurrent cisplatin plus 5-fluorouracil (PF), and 44 received concurrent docetaxel plus cisplatin (TP). Treatment response was evaluated at 1--3 months after CCRT. With a median follow-up of 34 months (range, 2--116 months), the 3-year overall survival (OS) of all the patients was 51.8% and the median OS time was 43.0 months. The overall tumor response rate was 75.9% (63/83), with a complete remission (CR) rate of 44.6% (37/83). In univariate analysis, tumor response after CCRT (p = 0.000), recurrence site (p = 0.028) and concurrent chemotherapy (p = 0.090) showed a trend favoring better OS. Multivariate analysis revealed that tumor response after CCRT (p = 0.000) and concurrent chemotherapy (p = 0.010) were independent predictors of OS. Forty-seven patients had progressive diseases after CCRT, 27 had local failure (27/47, 57.4%), 18 had distant metastasis (18/47, 38.3%) and 2 had both local and distant failures (2/47, 4.3%). 3DCRT-based CCRT is effective in postoperatively recurrent esophageal SCC. Patients that obtained complete remission after CCRT appeared to achieve long-term OS and might benefit from concurrent TP regimen. Local and distant failures remained high and prospective studies are needed to validate these factors.
    Radiation Oncology 10/2013; 8(1):241. · 2.11 Impact Factor
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    ABSTRACT: BACKGROUND: The 7th edition of the American Joint Committee on Cancer (AJCC) cancer staging manual incorporates tumor grade and location for staging pT2-3N0M0 esophageal squamous cell carcinoma. Patients with pT3N0M0, classified as stage IIa according to the 6th edition of the AJCC cancer staging manual, can now be classified as stage Ib, IIa, or IIb. We aimed to discuss whether these changes affect survival and determine other potential prognostic factors. METHODS: We retrospectively analyzed 302 patients with postoperative pathologic stage T3N0M0 who underwent esophagectomy between 1990 and 2005 at Sun Yat-sen University Cancer Center. We performed univariate and multivariate analyses to identify prognostic factors for survival and used the Kaplan-Meier method to compare survival difference in each prognostic factor, including tumor grade and location. RESULTS: The 5-year overall survival rate was 46 %, with a median survival of 1,244.5 days. Gender, age, alcohol consumption, forced expiratory volume in 1 s (FEV1), and number of removed lymph nodes were independent prognostic factors in both univariate and multivariate analyses. Smoking was also a prognostic factor in survival analysis by the Kaplan-Meier method. However, histologic tumor grade and location had no significant influence on patient survival. CONCLUSIONS: Age, gender, alcohol consumption, FEV1, number of removed lymph nodes, and cigarette smoking are independent prognostic factors in patients with pT3N0M0 esophageal squamous cell carcinoma. However, tumor grade and location may not be as strong predictors in these patients as indicated in the 7th edition of the AJCC cancer staging manual.
    Annals of Surgical Oncology 09/2012; · 4.12 Impact Factor
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    ABSTRACT: Smoking is well known as a risk factor for esophageal cancer, but controversial as a prognostic factor. Moreover, evidence is scarce that a dose-response relationship exists. We conducted a retrospective study on the effect and dose-response relationship of prediagnostic smoking on the postoperative disease-specific survival of patients with lymph node-negative esophageal squamous cell carcinoma (ESCC). We enrolled 643 patients with lymph node-negative ESCC who had undergone esophagectomy between 1990 and 2005 at the Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China. The patients' demographic, pathological, preoperative and cancer outcome data were obtained from medical records. These data were reviewed and analyzed using life table, Kaplan-Meier analysis and multivariate Cox regression. A significant reduction in 3- and 5-year survival rates was observed in smokers with lymph node-negative ESCC compared with those in non-smokers. The 3- and 5-year survival rates were 54% and 46% for smokers, and 67% and 64% for non-drinkers, respectively (P < 0.05). Multivariate Cox analysis revealed that smoking was an independent prognostic factor (P = 0.008, hazard ratio = 1.404). Both log-rank test (P = 0.065) and multivariate analysis (P = 0.091) showed no significant difference between the survival rates of light and heavy smokers. Prediagnostic smoking is an independent prognostic factor for patients with lymph node-negative ESCC, but the dose-response relationship needs further investigation.
    Cancer Science 08/2012; · 3.48 Impact Factor
  • Jingeng Liu, Dongping Rao, Jianhua Fu
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 06/2012; 42(4):759-60. · 2.40 Impact Factor
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    ABSTRACT: OBJECTIVES; The demographic and clinicopathologic factors associated with 5-year survivors have not been well documented in oesophageal squamous cell carcinoma (OSCC). We evaluated factors predictive of actual 5-year survival in the present research. We analysed 1241 patients underwent oesophagectomy for invasive OSCC retrospectively. The demographic and clinicopathologic characteristics were compared between patients who were alive >5 years after oesophagectomy and patients who died within 5 years of oesophagectomy. Univariate analysis showed significant differences between the two groups regarding 11 different factors. Further analysis by logistic regression showed that eight factors were identified as independent predictors of actual 5-year survival. The independent positive predictors for actual 5-year survival are younger patients, female gender, absence of weight loss, R0 resection, lower pathological T stage, lower pathological N stage, higher histologic grade and more resected lymph nodes.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 12/2011; 41(3):e7-11. · 2.40 Impact Factor
  • Jingeng Liu, Yi Hu, Xuan Xie, Jianhua Fu
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    ABSTRACT: Subcarinal node metastasis is common in patients with esophageal cancer. Some scholars have suggested that subcarinal nodes might not need to be sampled or dissected in patients with superficial squamous cell carcinoma of the thoracic esophagus. This research investigated the frequency of subcarinal node metastasis in patients with esophageal squamous cell carcinoma, identified the factors correlated to subcarinal node metastasis, and evaluated the clinical relevance of subcarinal node metastasis in thoracic esophageal squamous cell carcinoma. We retrospectively analyzed the clinical data of 1,812 consecutive patients with thoracic esophageal squamous cell carcinoma who underwent esophagectomy in the Cancer Center of Sun Yat-sen University. The surgical procedures included the left transthoracic procedure, Ivor-Lewis approach, and the cervical-thoracoabdominal procedure. The frequency of subcarinal node metastasis was 10.0%. The univariate and multivariate analysis showed that longer tumor length, higher pathologic T stage, lower histologic grade, and positive lymph node metastases of other groups were associated with a higher frequency of subcarinal node metastasis (all p<0.05). Patients with solitary subcarinal node metastasis had a significantly lower 5-year cumulative survival rate than those with solitary paraesophageal node metastasis (25.3% vs 39.6%, p<0.05). Longer tumor length, higher pathologic T stage, lower histologic grade, and positive lymph node metastases of other groups are associated with a higher frequency of subcarinal node metastasis. Subcarinal node metastasis indicates worse prognosis of patients with thoracic esophageal squamous cell carcinoma compared with paraesophageal node metastasis.
    The Annals of thoracic surgery 12/2011; 93(2):423-7. · 3.45 Impact Factor
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    ABSTRACT: The use of metal stents for malignant esophageal strictures for palliation is well accepted. However, utilization of metal stents for benign esophageal diseases has been controversial. Given the availability of removable, fully covered, self-expandable metal stents (RFCSEMSs), this study was undertaken to evaluate the effectiveness and safety of RFCSEMSs in patients with refractory benign esophagogastric anastomotic strictures. Twenty-four patients with RFCSEMSs were enrolled in this study. All patients had undergone endoscopic Savary-Gilliard bougie dilatation five times or more but there was no significant improvement in symptoms. For all 24 patients, the symptom of dysphagia was alleviated significantly while the stent was in place and for a short time after stent removal, and dysphagia scores decreased from 3-4 to 0-1. After 12 months of follow-up, 18 patients were free from dysphagia but the other 6 patients still suffered obvious dysphagia. RFCSEMSs are still not perfect and can induce some complications. The treatment failure rate of restenting was remarkably high after the first failure. Given that effective methods for treating refractory stricture have not been found, RFCSEMSs could be considered for treating refractory benign esophagogastric anastomotic stricture.
    Dysphagia 08/2011; 27(2):260-4. · 1.94 Impact Factor
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    ABSTRACT: Bronchopulmonary carcinoid (BPC) account for less than 2% of all primary lung malignant tumors, but few related studies were reported. The aim of this study is to analyze this rare disease's clinicopathological characteristics. The clinical data of 28 patients with BPC in Cancer Center of Sun Yat-sen University, from January 1994 to June 2009, were enrolled into retrospective analysis. First, the corresponding paraffin blocks reexamined, slice up and stained, multiple pathologists re-consulted, and its subsets (typical carcinoid, TC; atypical carcinoid, AC) defined. Second, the clinical characteristics and immunohistochemical markers and its relationship with prognosis were analyzed. First, the 5-year survival for overall and TC, AC was 56% and 70%, 41% respectively in 28 cases. The markers CD99, Bcl-2 and Ki-67 expression correlated significantly with the BPC subsets (P = 0.017, P = 0.043, and P = 0.033 respectively). Further univariate analysis revealed that advanced TNM staging (P = 0.037), lymph node metastasis (P = 0.001) and Ki-67 nucleolus's positive expression (P = 0.009) are poor prognostic factors. Second, the overall, TC, AC 5-year survival rate was 73%, 83%, 57% respectively in 20 cases underwent the radically surgical resection. Further univariate analysis revealed that AC subset (P = 0.013), lymph node metastasis (P = 0.004) and Ki-67 nucleolus's positive expression (P = 0.006), advanced TNM staging (P = 0.047) are poor prognostic factors in this 20 cases. Third, as univariate analysis, local recurrence and metastasis (n = 4) correlate significantly with Ki-67 nucleolus's and Bcl-2 positive expression (P = 0.027, 0.045, respectively). The prognosis of BPC was better than other types of primary lung cancer. Ki-67, Bcl-2 high expression and advanced TNM staging are the poor recurrence and prognostic factors of BPC. The radical surgery remains the treatment of choice for resectable candidates in BPC as NSCLC.
    Zhongguo fei ai za zhi = Chinese journal of lung cancer 06/2010; 13(6):591-7.
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    ABSTRACT: Inhibitor of differentiation 1 (Id1) plays a role in cellular differentiation, proliferation, angiogenesis and tumor invasion. In current study, we investigated the expression of Id1 protein in 189 specimens of stage III ESCC by immunohistochemistry. The correlation between Id1 expression and clinicopathological parameters in terms of gender, age, tumor location, differentiation, pathological T stage and pathological N stage was also explored. Immunohistochemical staining showed that Id1 was expressed in all cases (100%). According to ROC curve, we selected 6.33 as the cutoff score. There were 95 cases in high expression group (> 6.33) and 94 cases in low expression group (⩽ 6.33) respectively. The Id1 expression was associated negatively with differentiation, and positively with pathological N stage (P< 0.05, bothly); No significant correlation was observed between Id1 expression and gender, age, tumor location or pathological T stage (P> 0.05). As shown by the Kaplan-Meier curve, the overall survival rate of high expression group was significantly lower than that of low expression group (P< 0.001). The expression of Id1 protein has a close relationship with differentiation degree, pathological N stage and survival in ESCC patients. Id1 could be considered as a prognostic predictor for stage III ESCC patients.
    Cancer biomarkers: section A of Disease markers 01/2010; 8(2):67-72. · 0.97 Impact Factor
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    ABSTRACT: OBJECTIVE It has been shown that application of molecular biological techniques to surgical margins of some cancers could predict risk of local recurrence. However, the optimal length of surgical resection with tumor-free surgical margins for esophageal squamous cell carcinoma (ESCC) is unknown. This study was conducted to evaluate the optimal length of surgical resection for ESCC with molecularly tumor-free surgical margins marked by p53 and Ki67. METHODS Surgical specimens from 70 patients with ESCC were collected for study. The lengths of the upper margin, tumor, and lower margin of every specimen were measured during the operation. Each specimen was divided into three large pathologic sections, stained with H&E and immunohistochemically for p53 and Ki67, and examined microscopically. The lengths of the upper and lower resection ends were measured for p53 and Ki67 positive expression. The actual surgical lengths were calculated by the principle of rational shrinkage. RESULTS All surgical margins were histologically tumor-free, while the positive rates of p53 and Ki67 were 66% and 54%. The positive rates of p53 and Ki67 in the upper resection end were 17% and 20%. The mean lengths of the upper resection end showing p53 and Ki67 positive expression were 1.08±1.12 cm and 1.64±1.01 cm, and the maximum lengths were 3.73 cm and 3.26 cm. The positive rates of p53 and Ki67 in the lower resection end were 20% and 23%. The mean lengths of the lower resection end of p53 and Ki67 with positive expression were 1.11±1.15 cm and 1.34±0.94 cm, and the maximum lengths were 3.73 cm and 3.61 cm. CONCLUSION The optimal length of surgical resection with molecularly tumor-free surgical margins of ESCC is not more than 5 cm.
    Chinese Journal of Clinical Oncology 09/2006; 3(5):315-321.
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    ABSTRACT: ObjectiveIn Europe and America breast cancer commonly occurs in women of middle and old age, with a median age of about 57 years. Modified radical mastectomy now called standard radical mastectomy, has taken the place of traditional radical mastectomy. Patients with breast cancer at an early stage commonly receive BCT (breast conservative therapy). The TNM stage (especially the lymph node status) affects the prognosis, and adjuvant therapy can improve survival. In China, only a few reports have been published studying large numbers of breast cancer patients. This study was designed to analyze the clinical features, surgical pattern and treatment outcome of resectable breast cancer, as well as to explore the prognostic factors and the effect of adjuvant therapy, with a goal to improve the level of diagnosis and treatment. MethodsRecords of the 6,263 patients with resectable breast cancer who had been admitted into our hospital from June 1964 to June 2003 were analyzed retrospectively. ResultsOf the 6,263 cases, 98.8% were female. Breast cancer occurred most frequently in patients of ages 40∼49 years (41.0%), especially in patients 45∼49 years old (25.2%). A breast lump, which occurred in 96.2% of the patients, was the main clinical manifestation. The overall 5- and 10-year survival rates were 75.16% and 40.44%. Of the patients in TNM stages 0-I, II, and III, the 5-year survival rates were 96.8%, 73.7% and 46.4% respectively and the 10-year survival rates were 78.7%, 64.6% and 33.5% respectively. The 5-, and 10-year survival rates were higher in the lymph node negative group than in the lymph node positive group (80.3% vs. 55.6%, and 59.2% vs. 31.9%,P<0.01). Since the 1980s there was no significant difference in survival rates of patients who received a radical mastectomy compared to a modified radical mastectomy(P>0.05). Of the 73 patients who underwent breast conservative therapy, no local recurrence or metastasis occurred during a maximal follow-up of 17 years. Of the patients in stage T2-T4, the 5-, and 10-year survival rates were significantly higher in the group treated with adjuvant chemotherapy compared to the non -chemotherapy group (78.2% vs. 60.1%, and 48.9% vs. 30.7%,P<0.01). ConclusionAccording to our data, breast cancer most frequently occurred in patients of ages 45∼49 years. The TNM stage (especially the lymph node status) relates to breast cancer prognosis. The prognosis was worse in patients with positive lymph nodes compared to the patients with negative lymph nodes. The efficacy of a modified radical mastectomy is equal to that of a radical mastectomy, and breast conservative therapy can be applied to patients in an early stage. Adjuvant chemotherapy and endocrine therapy can improve the survival of resectable breast cancer patients.
    Chinese Journal of Clinical Oncology 01/2005; 2(5):761-766.
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    ABSTRACT: To identify predictors of survival following pneumonectomy for non-small cell lung cancer (NSCLC) and provide evidence for the revision of patient selection criteria. 81 cases of pneumonectomy for NSCLC from January 1990 to May 1996 at our hospital were reviewed retrospectively. There were 65 men (80.2%) and 16 women (19.8%), with a mean age 53.4 +/- 9.4 years (range 20 - 68 years). Predominant histological types included squamous cell carcinoma (54.3%), adenocarcinoma (24.7%), and squamoadenocarcinoma (17.3%). After follow-up for more than 5 years, data were examined using the chi-square test, Kaplan-Meier method, and Cox-mantel test. The possible factors affecting survival were tested with univariate and multivariate analysis. The 5-year survival of N(0), N(1) and N(2) disease of NSCLC following pneumonectomy was (20.8 +/- 9.9)%, (15.4 +/- 10.0)% and (4.0 +/- 2.8)%, respectively. There was no perioperative death. The operative complications morbidity was 22.2%. Factors adversely affecting survival with univariate analysis included age over 60 years for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, peripheral location, tumor greatest dimension more than 10 cm, chest wall involvement and N(2) disease. Factors adversely affecting survival with multivariate analysis included cardiopulmonary complications, greatest tumor dimension more than 10 cm, chest wall involvement and N(2) disease. Pneumonectomy provides survival benefit with a high operative complications morbidity. Old age (>/= 60 years) for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, and N(2) disease may be negative prognostic factors of long-term survival. Patient selection should be based on cardiopulmonary evaluation and the stage of disease.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 09/2002; 40(8):567-70.
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    ABSTRACT: To evaluate the value of mediastinoscopy in diagnosing unknown mediastinal disease and staging of lung cancers. From October 2000 to August 2001, 41 patients were examined by cervical mediastinoscopy with or without anterior mediastinotomy for diagnostic and staging purposes. Of these 41 patients, 12 were for diagnosis of unknown mediastinal disease, 3 for diagnosis and staging of pulmonary nodule or mass clinically suspected to be malignancy and 26 for the staging of lung cancer. Ten of 12 patients with unknown mediastinal disease were diagnosed pathologically as thymoma in 1, metastatic lesion from lung cancer in 1, metastatic thyroid carcinoma in 1, lymph node hyperplasia in 1, teratoma in 1, sarcoidosis in 1, inflammatory pseudotumor in 1 and tuberculosis in 3, giving a diagnostic rate of 83.3%. Of three patients with suspected malignancy, one was diagnosed as tuberculosis by cervical mediastinoscopy and the other two as lymphoma and pulmonary inflammatory pseudotumor by thoracoscopy and thoracotomy. The sensitivity and specificity of mediastinoscopy for the staging of mediastinal nodes in 26 lung cancers were 87.5% and 100%. Only one wound infection but no other major complication was found. Mediastinoscopy is a safe procedure which can accurately provide information on diagnosis and staging.
    Zhonghua zhong liu za zhi [Chinese journal of oncology] 02/2002; 24(1):74-6.

Publication Stats

22 Citations
29.35 Total Impact Points

Institutions

  • 2013–2014
    • State Key Laboratory of Medical Genetics of China
      Ch’ang-sha-shih, Hunan, China
  • 2005–2014
    • Sun Yat-Sen University Cancer Center
      Shengcheng, Guangdong, China
  • 2010–2013
    • Sun Yat-Sen University
      • Department of Thoracic Surgery
      Shengcheng, Guangdong, China
  • 2002
    • Sun Yat-Sen University of Medical Sciences
      • Cancer Center
      Guangzhou, Guangdong Sheng, China