外阴癌转移复发分析

目的:总结影响外阴癌预后、转移复发的相关因素,探讨理想的治疗方法。方法:分析本院1970年1月至2000年1月收治的162例外阴癌,比较不同治疗方法、分期以及不同复发时间、部位对5年生存率的影响。结果:162例患者总的5年生存率为60.5%,其中外阴鳞癌5年生存率为68.7%。复发率为34.3%,复发部位单纯外阴占40.0%,腹股沟淋巴结占42.2%,盆腔淋巴结转移占6.7%,远处转移11.1%。结论:外阴癌复发者外阴白斑发病比例高于未复发者(P<0.05),复发部位是影响预后的重要因素,2年内复发者预后差。外科手术是影响外阴局部复发的主要因素。     

肺癌根治术后复发转移的探讨

探讨肺癌根治术后复发,转移的特点,为术后复查和治疗提供依据。方法采用ＳＴＡＴＡ统计软件,建立病例资料数据库,并进行统计分析,生存率采用寿命表法计算,不同分组之间差异的显著性采用ｌｏｇｒａｎｋ检验。两组间复发,转移率差异的显著性用Ｘ＾２检验。结果术后局部复发率鳞癌高于腺癌,其他病理类型之间差异无显著性。     

外阴癌复发和转移

外阴癌疗后复发文献中很少报道,我院从1958年3月至1989年12月共收治外阴癌301例,随诊中发现外阴局部复发22例,外阴局部复发伴腹股沟淋巴结转移9例,腹股沟淋巴结转移11例。本文通过临床分析,探讨局部复发和区域淋巴结转     

肾癌术后复发转移的再手术探讨

国内外文献有关肾癌术后复发、转移再手术的报道较少。自１９８７年５月～１９９７年６月，我们对６例肾癌根治术后复发、转移患者成功地进行了再手术治疗，现报告如下。１临床资料本组６例中，男性５例，女性１例。年龄２２～６４岁。左肾癌５例，右肾癌１例，均作肾癌根...     

肝细胞癌根治术后复发转移的预测

许多因素与肝细胞癌术后复发转移有关,包括患者的一般状态、肿瘤大体病理学特征和病理组织学特征等相关因素.随着对肿瘤生物学特征的进一步了解以及分子生物学技术的发展,近年来发现许多与肝细胞癌转移复发相关的分子标记物,如甲胎蛋白-L3、甲胎蛋mRNA、γ-谷氨酰转肽酶Ⅱ、α-L-岩藻糖苷酶、骨桥蛋白等.     

结肠癌根治术后复发转移风险模型的初步建立及评估

目的初步建立并评估一个结肠癌术后复发转移的风险预测模型。方法回顾分析2009年6月至2013年6月间收治的240例结肠癌患者临床资料,通过Logistic回归分析建立模型,受试者工作特征(ROC)曲线评估模型。结果模型公式为:Ln[p/(1-P)]=3.63×淋巴结转移+2.64×B期+3.20×C期-2.63。模型受试者工作特征(ROC)曲线下面积为0.92,模型风险预测值为0.68。结论该模型能在一定程度上预测结肠癌根治术后复发转移风险。     

胃癌根治术后早期复发转移的影响因素分析

摘 要：［目的］ 探讨胃癌根治术后早期复发转移的影响因素。［方法］ 回顾性分析232例胃癌根治术后复发转移患者的临床病理特征,分析患者术后早期复发转移的影响因素。［结果］ 232例患者中位复发时间为术后17.3个月（95%CI：15.0~19.6）,早期复发转移（复发转移时间≤ 24个月）153例（65.9%）,晚期复发转移（复发转移时间＞24个月）79例（34.1%）。多因素分析显示神经侵犯(P=0.009)、术后并发症（P=0.013）是根治术后早期复发转移的独立危险因素。［结论］神经侵犯、术后并发症与胃癌根治术后早期复发转移相关。     

结肠癌根治术后复发转移危险因素分析

[目的]探讨结肠癌患者根治术后复发转移的相关临床病理因素.[方法]选择1994年1月至2004年1月行结肠癌根治术患者446例,Cox模型分析临床病理因素与复发转移的关系.[结果]全组复发转移率为19.28%.单因素分析显示,发病至手术的时间、术前CEA水平、分化程度、Dukes＇分期、淋巴结转移与术后复发转移有关;多因素分析显示淋巴结转移、分化程度、术前血清CEA水平是术后复发转移预后因素.[结论]分化程度、淋巴结转移、术前血清CEA水平是影响结肠癌患者根治术后复发转移的重要预后因素.     

围手术期输血对乳腺癌术后复发转移的影响

目的：探讨围手术期输血对乳腺癌术后复发转移的影响.方法：对427例乳腺癌根治术患者的围手术期输血情况和术后复发转移情况进行回顾性分析.结果：围手术期输血组术后1、2和3年局部复发率分别为10.5%（4/38）、15.8%（6/38）和18.4%（7/38）,而未输血组术后1、2和3年局部复发率分别为2.6%（10/389）、5.1%（20/389）和6.7%（26/389）,两组差异有统计学意义,X2值分别为4.60、5.20和5.13,P值均＜0.05;围手术期输血组术后1、2和3年远处转移率分别为7.9%（3/38）、10.5%（4/38）和13.2%（5/38）,而未输血组术后1、2和3年远处转移率分别为1.0%（4/389）、2.3%（9/389）和3.1%（12/389）,两组差异有统计学意义,X2值分别为6.69、5.35和6.74,P值分别＜0.01、＜0.05和＜0.01.结论：围手术期输血对乳腺癌术后复发转移具有显著影响,建议手术医生应该通过提高手术技术和围手术期处理水平而减少出血和避免输血.     

肺腺癌根治术后复发与转移的预后因素分析

目的 探讨肺腺癌根治术后局部复发与远处转移的危险因素.方法 收集2005年1月至2010年1月新疆医科大学第一附属医院收治的102例接受肺叶切除肺腺癌病例,对影响其预后的临床病理因素进行单因素及多因素分析,采用Kaplan-Meier绘制生存曲线,采用Log-rank检验单因素统计学差异,采用COX回归比例风险模型对预后影响因素进行多因素分析.结果 全组1、2、3、5年无瘤生存率分别为74.30％、58.00％、51.50％、44.90％,总的中位无瘤生存期为30个月.单因素分析结果显示,肿瘤直径(x2=9.951,P=0.002)、临床类型(χ2=8.460,P=0.004)、肿瘤分化程度(χ2=4.807,P=0.028)、淋巴结转移情况(χ2=40.516,P=0.000)、病理分期(x2 =38.769,P=0.000)是影响肺腺癌患者根治术后局部复发和远处转移的预后因素.多因素分析结果显示,肿瘤直径(OR=1.943,95％ CI为1.091～3.463,x2 =5.082,P=0.024)、肿瘤分化程度(OR =2.570,95％ CI为1.451～4.552,x2=10.467,P=0.001)、淋巴结转移情况(OR=3.196,95％ CI为1.037～9.849,x2 =4.096,P=0.043)是影响患者术后局部复发和远处转移的独立预后因素.结论 对于肺腺癌根治术的患者,肿瘤直径、肿瘤分化程度、淋巴结转移情况是独立的预后因素.     

股前外侧皮瓣在外阴肿瘤术后的修复应用

目的：评价股前外侧皮瓣在外阴肿瘤术后缺损修复中的应用价值。方法：应用带旋股外侧动脉降支和股前外侧皮神经为蒂的股前外侧皮瓣一期修复外阴肿瘤术后缺损１０例,皮瓣大小为１０ｃｍ×１４ｃｍ～１４ｃｍ×２０ｃｍ。结果：１０例皮瓣全部成活,随访２～１２个月,外观满意,皮瓣感觉功能存在,局部肿瘤无复发。结论：股前外侧皮瓣血管蒂长,血管口径大,供瓣区隐蔽。带感觉神经的股前外侧皮瓣是一种适合外阴肿瘤术后缺损修复的理想皮瓣。     

Cross analysis of recurrent types after radical resection of colorectal carcinoma

Objective  

To provide the evidence of predicting and preventing the postoperative recurrence by investigating the relationship between the recurring types of colorectal carcinoma (CRC) after radical resection and clinicopathologic factors.     

Hepatic resection following systemic chemotherapy for metastatic colorectal carcinoma.

Increasingly effective systemic chemotherapy has improved responses in patients with previously unresectable colorectal hepatic metastases. In the future, response to chemotherapy may define a new population of patients that may benefit from hepatic resection. A retrospective review to determine the safety and effectiveness of potentially curative hepatic resection of metastatic colorectal carcinoma after systemic chemotherapy identified 11 such patients with resections between July 1987 and October 1991. Five patients had unresectable disease confined to the liver, two had hepatic and limited extrahepatic metastases, two had hepatic recurrences after previous hepatic metastasectomy, and two had initially resectable liver metastases. These patients were resected after a mean of 8 months of systemic chemotherapy. Complications, usually minor, occurred in five patients (45%). There were no deaths. Three patients are disease free at 15, 18, and 31 months (mean 21) after hepatic resection. Eight patients have recurred with a median time to recurrence of 8 months. Five patients have subsequently died of recurrent disease. This study suggests that hepatic resection following systemic chemotherapy can be performed safely and may benefit selected patients.     

A case of recurrent metastatic hepatocellular cancer controlled with immunotherapy and antiviral therapy following resection

Hepatocellular carcinoma (HCC) is the most frequent malignant tumour of the liver. The risk of HCC in chronically hepatitis B virus (HBV) infected individuals is approximately 100-fold higher than in the uninfected population. Despite all therapeutic advances, the benefit of systemic chemotherapy in patients with HCC has limited. But, the phase III clinical trial conducted in patients with advanced HCC treated with sorafenib has showed significant improvements in both overall and progression-free survival Metastasis from liver to extrahepatic tissues is reported to be quite uncommon and has a poor prognosis. Here we present a case of HCC which metastasized to the vertebrae, lung and kidney in order of appearance and controlled with immunotherapy and antiviral therapy following resection.     

A young woman with distant recurrent metastatic primary vaginal carcinoma salvaged with radical radiotherapy

The incidence of distant recurrent metastatic primary vaginal carcinoma is rare. The prognosis in such cases is poor, with cure being extremely rare. We report the case of a young woman, with distant recurrent metastatic primary vaginal carcinoma in which the patient remains disease-free 5 years after completing salvage radical radiotherapy. The clinical management of recurrent metastatic primary vaginal carcinoma must be tailored to the site of recurrence and the patient's performance status. Complete clinical remission and long-term survival without evidence of disease may be achieved in rare cases with radical radiotherapy.     

Prognostic significance of peri-operative blood transfusion following radical resection for oesophageal carcinoma.

INTRODUCTION: Peri-operative allogeneic blood transfusion may exert an immunomodulatory effect and has been associated with early recurrence and decreased survival following resection for several gastro-intestinal malignancies. The aim of this study was to evaluate the prognostic influence of transfusion requirements following radical oesophagectomy for cancer. METHODS: A consecutive series of 235 patients undergoing subtotal oesophagectomy with two-field lymphadenectomy in a single centre from April 1990 to June 1999 were studied. RESULTS: The median age was 64 years (30-79) with a male to female ratio of 3:1. The predominant histological subtype was adenocarcinoma (n = 154) compared to squamous carcinoma (n = 81). To avoid the influence of surgical complications data were excluded from the 5.5% of patients suffering in-hospital mortality. In the remaining patients, median blood loss was 900 ml (200-5500) with 46% (103/222) requiring transfusion (median 3 units, range 2-21). Median survival of non-transfused patients was 36 months compared to only 19 months for those receiving transfusion (log-rank = 4.44; 1 df, P = 0.0352). Non-transfused patients had significantly higher 2 and 5-year survival rates of 62% and 41% respectively in contrast to only 40% and 25% in those receiving blood transfusion. Even after stratification of results according to disease stage or the presence of major complications, survival was significantly worse in those receiving transfusion. Multivariate analysis demonstrated that in addition to nodal status, > 4 units transfusion was an independent prognostic indicator. CONCLUSION: Post-operative transfusion is associated with a significantly worse prognosis following radical oesophagectomy. Meticulous haemostasis and avoidance of unnecessary transfusion may prove oncologically beneficial.     

Pattern of recurrence following complete resection of esophageal carcinoma and factors predictive of recurrent disease

BACKGROUND: Despite increasingly radical surgery for esophageal carcinoma, a large number of patients still experience recurrent disease soon after operation. The current study was undertaken to evaluate the pattern of recurrence after curative esophagectomy for cancer of the thoracic esophagus and to identify factors predictive of recurrent disease. METHODS: A total of 439 consecutive patients discharged from the authors' institution following R0 resection between January 1982 and July 2002 were followed for evidence of recurrence over a mean interval of 37.3 (range, 1-207) months. RESULTS: Overall 1-, 3- and 5-years survival rates were 91%, 54%, and 41%, respectively. Some 230 patients (52.4%) developed proven recurrence, of whom 24 were alive and 206 were dead at the time of writing. The median time to recurrence was 12.0 (range, 6-96) months, with a median survival thereafter of 7.0 (range, 0-83) months. The pattern of recurrence was local in 12.1%, regional in 20.5% (cervical 3.6%, mediastinal 14.8%, and abdominal 2.1%), and distant in 19.8%, respectively. The overall pattern of dissemination was significantly different according to the histologic subtype (P = 0.021). One hundred five (45.7%) of all recurrences occurred within 12 months of surgery, with local, regional, and distant recurrence occurring at a median of 14.0 (range, 6-77), 13.5 (range, 6-73), and 11.0 (range, 6-96) months, respectively; A factor predictive of recurrent disease was histologic tumor depth invasion (P = 0.001). CONCLUSIONS: Depth of tumor invasion should be used to identify patients who will have recurrence within 12 months of operation, so that these patients may be either entered into trials of multimodality treatment or offered nonsurgical palliation.     

Combined chemotherapy for recurrent and metastatic nasopharyngeal carcinoma

Thirty-two patients (24 males, 8 females; median age 54 yrs) with recurrent and/or metastatic undifferentiated carcinoma of the nasopharyngeal type were treated with chemotherapy. Remissions were observed in 17 of 32 (53.2%) with 5 complete (CR) (15.6%) and 12 partial responses (PR) (37.6%). A combination of cisplatin and 5-fluorouracil was the most effective regimen (CR + PR = 83.3%). Objective responses. (CR + PR) were 47% (CR = 11.7%) in schemes without cisplatin and 60% (CR = 20%) in cisplatin-based combinations. The median overall duration of response was 7.2 months. The median overall survival time was 10.3 months: 15.1 months for responders and 5.2 for non-responders. No important toxicity was observed.