Study of the Value of Combined Multiorgan Resection in Surgical Treatment of Carcinoma of the Gastric Cardia

OBJECTIVE:To determine the value of resection of combined visceral organs in surgical treatment of gastric cardiac carcinoma. METHODS:We retrospectively analyzed 217 random patients with car- cinoma of the gastric cardia who underwent a gastric cardiac resection.The patients had been treated as fol ows:186 with partial gastrectomy,31 with total gastrectomy,97 with a combined-visceral resection,of which 82 under- went a splenectomy plus partial pancreatectomy,10 with splenectomy alone and 5 with partial hepatectomy and diaphragmatectomy. RESULTS:The total patients were divided into 3 groups:128 with a gas- trectomy alone,10 with gastrectomy and splenectomy,and 82 with gastrec- tomy and splenectomy plus pancreatectomy.The operating times for these 3 groups were respectively 3.0 h,3.1 h and 3.8 h.The hospitalization times were respectively 23.8 d,31.2 d and 25.9 d.No differences in post-operative complications were found between these 3 groups.There were 92 patients who underwent a gastrectomy combined with a splenectomy and(or)the pancreatectomy,in which 92 No.10 lymph nodes were eliminated,with an average of one in each patient.Among the 125 patients not receiving a sple- nectomy but with elimination of lymph nodes,82 underwent a gastrectomy combined with partial pancreatectomy,of which 107 lymph nodes were elimi- nated for the No.11 group,with an average of 1.3 in each patient.There was a statisticaly significant difference between the 2 groups.The overal survival rates were similar in the 3 groups showing no statistical differences, but was higher in the Stage III patients with a combined resection of multi- organs.For patients in the Stage IV without resection of multi-organs,the survival rate was higher,but there was no significant difference between the 2 groups. CONCLUSION:It is difficult to determine precisely the involvement of para-tumorous organs with the eye during an operation.Combining a sple- nectomy with a pancreatectomy does not increase the post-operative compli- cations following surgical treatment for carcinoma of the gastric cardia.The combination of a splenectomy and partial pancreatectomy results in a higher survival rate and has an important significance for eliminating the lymph nodes of group 10 and 11,especially for patients in Stage III.In the applica- tion of a resection combining multi-organs,the doctor should make every effort to decrease the trauma and the complications based on the condition that the cancerous tissue is totally resected.     

Measurement of Microcirculation of the Gastric Conduit

IntroductionThe standard reconstruction after esophagectomy isthe formation of a gastric tube with cervical or intratho-racic esophagogastrostomy.This type of reconstructionis associated with a considerable morbidity and mortal-ity due to anastomotic leakage of the esophagogastrosto-my.Although several etiological factors have beendiscussed to contribute to this clinically relevant com-     

Multi-Analysis of Non-Thyrogenous Masses of the Neck

OBJECTIVE To systematically analyze and summarize non-thyroge-nous masses of the neck(NTMN)by consideration of new areas,a large sample size and multiple-aspect analysis.METHODS Our research involved 3,125 NTMN cases.We summarized the proportion of various NTMN and the distribution of the neck diseases based on the new international classification.The clinical traits such as sexual proportion and age,etc,were analyzed along with the unknown pri-mary cervical metastatic carcinomas(UPCMC),multiple nodular NTMN and tubercular lymphadenitis.RESULTS There were 68 different diseases identified.Among all the NTMN,the percentage of metastatic carcinomas was 63.3%.The neck masses with a focus above the clavicle comprised 62.3% of the metastatic carcinomas whose focuses were clear.Moreover,other results almost sup-ported the “rule of 80%”.There was an obvious distribution of traits at every sub level.For example,there were 23 different diseases in level III,of which the most common was lymphoma.UPCMC made up 12.3% of all metastatic carcinomas.Multiple NTMN were composed of lymphoma,metastatic car-cinoma and tubercular lymphadenitis,etc.For tubercular lymphadenitis pa-tients,the patients without tubercular toxic symptoms comprised 77.1% of all tubercular lymphadenitis patients.CONCLUSION NTMN are complex and various,with a definite distribu-tion in each neck level.Data relating the sex ratio,UPCMC,multiple nodular NTMN and tubercular lymphadenitis to the clinical traits of NTMN will provide support for clinical applications.     

Measurement of Microcirculation of the Gastric Conduit

The standard reconstruction after esophagectomy is the formation of a gastric tube with cervical or intrathoracic esophagogastrostomy. This type of reconstruction is associated with a considerable morbidity and mortality due to anastomotic leakage of the esophagogastrostomy,. Although several etiological factors have been discussed to contribute to this clinically relevant complication ischemia is considered to be the most important one. It is evident that the formation of a gastric tube with mobilization of the stomach, ligation of the left gastric artery and short gastric arteries,     

Editorial Board of Chinese Journal of Cancer Biotherapy

Honorable Editor-in-Chief Zhang Youhui Immunology &Oncology; Beijing, China Editor-in-Chief Cao Xuetao Academician, Immunology &Oncology; Shanghai, China Advisers Ba Denian Academician, Immunology &Oncology; Beijing, China Gu Jianren Academician,Oncology; Shanghai, China Liu Xinyuan Academician, Molecular biology; Shanghai, China Wu Mengchao Academician, Oncology; Shanghai, China Wu Min Academician, Cytobiology &Genetics; Beijing, China     

Estimation of Time Trends of Incidence of Prostate Cancer – an Indian Scenario

Background: With increase in life expectancy, adoption of newer lifestyles and screening using prostatespecific antigen (PSA), the incidence of prostate cancer is on rise. Globally prostate cancer is the second mostfrequently diagnosed cancer and sixth leading cause of cancer death in men. The present communication makesan attempt to analyze the time trends in incidence for different age groups of the Indian population reportedin different Indian registries using relative difference and regression approaches. Materials and Methods: Thedata published in Cancer Incidence in Five Continents for various Indian registries for different periods and/orpublications by the individual registries served as the source materials. Trends were estimated by computing themean annual percentage change (MAPC) in the incidence rates using the relative difference between two timeperiods (latest and oldest) and also by estimation of annual percentage change (EAPC) by the Poisson regressionmodel. Results: Age adjusted incidence rates (AAR) of prostate cancer for the period 2005-2008 ranged from 0.8(Manipur state excluding Imphal west) to 10.9 (Delhi) per 105 person-years. Age specific incidence rates (ASIR)increased in all PBCRs especially after 55 years showing a peak incidence at +65 years clearly indicating thatprostate cancer is a cancer of the elderly. MAPC in crude incidence rate(CR) ranged from 0.14 (Ahmedabad)to 8.6 (Chennai) . Chennai also recorded the highest MAPC of 5.66 in ASIR in the age group of 65+. Estimatedannual percentage change (EAPC) in the AAR ranged from 0.8 to 5.8 among the three registries. Increase intrend was seen in the 5-64 year age group cohort in many registries and in the 35-44 age group in Metropolitancities such as Delhi and Mumbai. Conclusions: Several Indian registries have revealed an increasing trend inthe incidence of prostate cancer and the mean annual percentage change has ranged from 0.14-8.6.     

Neuropsychological performance and quality of life of 10 year survivors of childhood medulloblastoma

Purpose: Survivors of medulloblastoma, the most frequently occurring malignant brain tumor of childhood, suffer neuropsychological damage in the first decade after diagnosis. Cognitive performance, psychosocial functioning and quality of life were assessed in medulloblastoma survivors in the second decade after diagnosis. Methods: Ten year survivors were evaluated with a battery of neuropsychological tests, and self-report questionnaires regarding quality of life and emotional functioning. Clinical variables examined included the patients age at diagnosis, duration since diagnosis, treatment, and complications. Results: Sixteen medulloblastoma survivors [mean age at diagnosis: 7.2 years, range: 1–15 years; 6 males] were tested at a mean age of 22.2 years [range: 13.6–27.9 years]. All survivors had been treated with craniospinal radiation therapy; nine were treated with chemotherapy. Significant impairments were identified in more than 50 of survivors on tests within all neuropsychological domains, including attention, memory, visuospatial abilities, motor functioning, language, and executive functioning. Significant impairments were also identified in all psychosocial domains examined, including employment, ability to drive an automobile, participation in normal education, independent living, and dating history. Most importantly, quality of life scores, reported by both survivors and their caretakers, were in the normal range. Conclusion: Survivors of childhood medulloblastoma frequently suffer severe persistent deficits in a wide-range of neuropsychological functional domains. Nevertheless, survivors and their families do not report impaired quality of life. These severe neuropsychological and psychosocial deficiencies justify further attempts to reduce or delay the use of craniospinal radiation therapy for childhood medulloblastoma.     

Clinical Trial of Intrathecal Administration of 5-fluoro-2′-deoxyuridine for Treatment of Meningeal Dissemination of Malignant Tumors

Intrathecal administration of 5-fluoro-2-deoxyuridine (FdUrd) was performed in patients with meningeal dissemination of malignant tumors during the period from January 1996 to September 1998, and they were followed up until February 1999. The study population consisted of 23 patients: 12 with lung cancer, 4 with breast cancer, 2 with colon cancer, 1 with malignant lymphoma, 2 with glioblastoma and 2 with metastatic brain tumors of unknown origin. FdUrd was administered intrathecally through an Ommaya reservoir placed in the lateral ventricle initially at a dose of 1µg twice per week, and the dose was increased to 10µg and administration schedule was also increased every day. Headache and nuchal pain were relieved in all patients regardless of responsiveness to intrathecal FdUrd therapy as determined from the findings in the cerebrospinal fluid (CSF). Patients showed no side effects during the course of intrathecal chemotherapy except for slight nausea in two patients and dull headache in one. Sixteen of the 23 patients showed decreased cell number in the cerebrospinal fluid (CSF). Positive cytological findings in CSF became negative in 6 of the 23 patients, and the levels of CSF tumor markers were decreased in 14. Responsiveness to intrathecal administration of FdUrd was defined as response when both the cell number and tumor markers were decreased in both ventricular and spinal CSF or when the cell number was decreased in cases in which the tumor markers were not detected. Overall, 16 of the 23 patients (70%) showed complete or partial responses to intrathecal FdUrd therapy as determined from CSF findings.These results demonstrated the efficacy of intrathecal FdUrd chemotherapy without apparent neurotoxicity for treatment of meningeal dissemination of malignant tumors.     

Consumption of different types of meat and the risk of renal cancer: meta-analysis of case–control studies

Background Kidney cancers account for almost 2% of all cancers worldwide, with 150,000 new cases and 78,000 deaths from the disease occurring annually. An increase in the incidence of kidney neoplasm in western countries was noticed in the past few years. Between 1988 and 1992, the incidence of renal cancer per 100,000 person-year among males in USA, Norway, and France was 34.1, 9.00, and 16.10, respectively. Among females in the same countries, it was 5.70, 5.00, and 7.30, respectively. Although several individual case–control studies examined the association of meat intake and renal cancer risk, the results were inconsistent because of the insufficient statistical power of the individual studies. Therefore, the following meta-analysis was designed to help in clarifying the association. Methods Electronic search of MEDLINE, OVID, and PUBMED databases which have articles published between (1966 and 2006) was conducted to select studies for this meta-analysis. Statistical analysis Fixed and random-effects meta-analytical techniques were used to estimate the overall association between meat consumption and kidney cancer. Results Thirteen case–control studies were found. This meta-analysis supported a positive relationship between meat consumption and risk of renal cancer. Summary results indicated that there was from 20% to 22% higher risk of renal cancer among those in the highest relative to the lowest category of poultry and processed meat consumption. Consumption of all meat and red meat was associated with 27% and 30% higher risk, respectively. The increased risks were statistically significant. Conclusions Increased consumption of all meat, red meat, poultry, and processed meat is associated with an increase risk of kidney cancer. Reduction of meat consumption is an important approach to decreasing the incidence of kidney cancer in the general population. An erratum to this article is available at .     

Analysis of Clinicopathologic Features of Esophageal Carcinoma Patients Undergoing Surgery-a Report of 4,329 Cases

OBJECTIVE To investigate the clinicopathological features of esophageal carcinoma (EC) patients, and to analyze epidemiologic characteristics and the current situation of esophageal cancioma in the southern area of Hebei Province.METHODS A total of 4329 patients with esophageal cancinoma,undergoing surgery in the Fourth Hospital of Hebei Medical University during a period from January 1996 to December 2005,were selected. Collection and statistical analysis of the pathologic data were performed using a SAS 6.0 software package.RESULTS Over the past ten years, there has been a tendency for an increase in the mean age of EC onset (P ＜ 0.05), a downtrend in the percentage of squamous cancer (SqCa) (P ＜ 0.05) and an uptrend in the frequency of small cell carcinoma (P ＜ 0.05). In clinical stages, there was a drop in the percentage of Stage-Ⅱsquamous EC patients (P ＜ 0.05), and an increase in that of Stage-Ⅳ patients (P ＜ 0.05). There were statistical differences in sex, age,pathologic types, depth of infiltration, ratio of stages and lymph node metastasis, etc. Among the superior, middle and inferior segments of the EC diseased region (P ＜ 0.05).CONCLUSION It was relatively late for the EC patients from this area to see a doctor, resulting in a drop in the ratio of SqCa and an ascensus in that of small cell cancer. However, due to a low incidence of adenocarcinoma, no obvious ascending tendency was found in the frequency of this carcinoma over the past ten years.     

A case of hereditary persistence of α-fetoprotein: diagnostic usefulness of the subfraction profile

α-Fetoprotein is a well-established tumor marker for non-seminomatous germ cell tumors. Elevated α-fetoprotein levels, however, result from a variety of clinical conditions. Hereditary persistence of α-fetoprotein is a rare benign disorder in which serum α-fetoprotein levels are persistently elevated, but there are no disabilities and symptoms. A 35-year-old man was diagnosed with pT1 testicular embryonal carcinoma. Post-orchiectomy α-fetoprotein levels remained persistently elevated without clinical or radiographic abnormalities. His mother's elevated α-fetoprotein levels confirmed the diagnosis of hereditary persistence of α-fetoprotein. Lens culinaris agglutinin-reactive α-fetoprotein fractions have been reported as a useful diagnostic marker for non-seminomatous germ cell tumors; in this patient, its measurement showed high non-reactive α-fetoprotein levels, which indicated the low probability of residual tumors. The present case represents the third case of hereditary persistence of α-fetoprotein in Japan, and the first in which the α-fetoprotein subfraction was evaluated.     

An Investigation of the Potential Malignant Characteristics of Endometriosis

OBJECTIVE To investigate the potential malignant characteristics and pathogenesis of endometriosis as well as the role of human growth hormone and epidermal growth factor receptor in the pathogenesis of malignant transformation of endometriosis. METHODS The immunohistochemical S-P method was used to examine the expression of human growth hormone and epidermal growth factor receptor in the eutopic and ectopic endometrium of 84 cases of endometriosis. RESULTS The percentage of positive cases of human growth hormone in eutopic and ectopic endometrium was 90.77% （59/65） and 85.71% （72/ 84） respectively. The percentage of positive cases of epidermal growth factor receptor in eutopic and ectopic endometrium was 81.54% （53/65） and 89.29% （75/84） respectively. The positive rate of epidermal growth factor receptor in ectopic endometrium was higher than that in the eutopic endometrium but without a statistically significant difference （P〉 0.05）. CONCLUSION Endometriosis is caused by multiple factors, which possesses some biologic features of neoplastic tissue such as invasion and metastasis. Both human growth hormone and epidermal growth factor receptor are highly expressed in eutopic and ectopic endometrium, which lead directly or indirectly to the pathogenesis of endometriosis and promote the initiation and malignant transformation of endometriosis.     

Critical role of phosphorylation of serine 165 of YBX1 on the activation of NF-κB in colon cancer

Y-box binding protein 1 [YBX1] is a multifunctional protein known to facilitate many of the hallmarks of cancer. Elevated levels of YBX1 protein are highly correlated with cancer progression, making it an excellent marker in cancer. The connection between YBX1 and the important nuclear factor κB [NF-κB] has never been reported. Here, we show that overexpression of wild type YBX1 [WT-YBX1] activates NF-κB, suggesting that YBX1 is a potential NF-κB activator. Furthermore, using mass spectrometry analysis we identified novel phosphorylation of serine 165 [S165] on YBX1. Overexpression of the S165A-YBX1 mutant in either HEK293 cells or colon cancer HT29 cells showed dramatically reduced NF-κB activating ability as compared with that of WT-YBX1, confirming that S165 phosphorylation is critical for the activation of NF-κB by YBX1. We also show that expression of the S165A-YBX1 mutant dramatically decreased the expression of NF-κB-inducible genes, reduced cell growth, and compromised tumorigenic ability as compared with WT-YBX1. Taken together, we provide the first evidence that YBX1 functions as a tumor promoter via NF-κB activation, and phosphorylation of S165 of YBX1 is critical for this function. Therefore, our important discovery may lead to blocking S165 phosphorylation as a potential therapeutic strategy to treat colon cancer.     

Clinical Review of Iressa for the Treatment of NSCLC

Following development of basic science and the advancement of tumor molecular biology, molecular-target therapy has evolved as a new field for cancer treatment. The agents used act at specific target points such as receptors, kinases and signal transduction systems which are related to tumor growth. These actions result in inhibting proliferation, metastasis, vascularization, and promoting tumor apoptosis. Iressa （gefitinib） which is used for the treatment of NSCLC is a small molecular weight agent acting by inhibition of epidermal growth factor receptor-tyrosine kinase. Iressa was the first approved agent for target therapy for the treatment of NSCLC. This article focuses on the results from clinical trials and the potential of Iressa for the treatment of NSCLC.     

Contribution Invitation of The Chinese-German Journal of Clinical Oncology

The Chinese-German Journal of Clinical Oncology is an international professional academic periodical on oncology, being co-edited by China and Germany. The Journal, with the authors from around world, especially from China, is dominated in introducing the clinical experience of diagnosis and treatment as well as leading scientific research achievement in the tumor domain, in ad-