Rational Operation for Primary Gastric Carcinoma with Liver Metastasis

OBJECTIVE To investigate the prognosis of advanced gastric carcinoma patients with liver metastasis, and provide a foundation for rational operations. METHODS The operations and prognosis of 102 primary gastric carcinoma patients with liver metastasis were studied retrospectively. RESULTS In gastric carcinoma patients with H1 metastasis who underwent a resection operation, the 6-month, 1- and 2-year post-operative survival rates were 61%, 42% and 7%. There was a statistically significant difference in survival between resected and non-resected patients （P=0.000） in gastric carcinoma cases with H2 metastasis, resection operations resulted in 54%, 16% and 8% respective survival rates, with no significant difference compared to patients not receiving a resection （P=0.132）. Gastric carcinoma patients with H3 metastasis who received a resection operation showed 25%, 13% and 0% respective survivals with no significantly better prognosis compared to the non-resected cases （P=0.135）. There was no statistically significant difference in survival between the cases with or without peritoneal metastasis （P=0.152）. CONCLUSION A resection operation provides a better prognosis for gastric carcinoma patients with H1 metastasis independent of peritoneal metastasis, but resection has no benefit for gastric carcinoma cases with H2 or H3 metastasis. Peritoneal metastases are not the significant influencing factor for the prognosis of gastric cancer with liver metastasis.     

Clinical Significance of Lymph Node Sampling in Endometrial Carcinoma

OBJECTIVE To study the clinical significance of pelvic and para-aortic lymph node sampling in endometrial carcinoma.METHODS Data were analyzed from 311 patients who received surgical treatment in our hospital during the period from January 1995 to December 2002.Among the patients,197 underwent lymph node sampling or lymph-adenectomy.The patients were divided into 2 groups based on the nature of their lymph node dissection,i.e.a)The sampling group included 114 patients with an extrafascial hysterectomy or modified radical hysterectomy plus pelvic or paraaortic lymph node sampling of the abdominal aorta;b)The dis-section group,included 83 patients with a radical or modified radical hyster-ectomy plus systemic pelvic lymph node clearance or paraaortic lymph node dissection of the abdominal aorta.RESULTS The median of the sampling sites for lymph node removal was 5 in the sampling group,and the median of the lymph nodes removed was 15 per case.Lymph node metastasis was found in 8 cases.In the dissection group,the median of the cases for lymph node removal was 8,and the me-dian of the lymph nodes removed was 27 per case.Lymph node metastasis was found in 6 cases.The 5-year survival rates were 90.2% and 90.9% in the 2 groups,respectively.CONCLUSION Lymph node sampling of endometrial cancer is a good way of precisely finding lymphatic metastases,and is suitable for surgical staging without causing immoderate surgical treatment and without affecting the survival rate.     

Investigation of the Effect of Neoadjuvant Chemotherapy on Stage Ⅱ Breast Cancer

OBJECTIVE To investigate the effect of neoadjuvant chemotherapy in treatment of Stage Ⅱ breast cancer. METHODS The data from 113 patients with breast cancer of the same pathologic type in Stage Ⅱ,during the period of 1995 to 2001,were analyzed retrospectively.Among the patients,47 were treated with neoadjuvant chemotherapy,and 66 received no adjuvant therapy before surgery（control group）.After the patients of the neoadjuvant chemotherapy group had received 2 courses of chemotherapy with the CMF regimen,the surgical procedure was conducted. RESULTS Complete remission（CR）was attained in 9 of the 47 cases receiving neoadjuvant chemotherapy and partial remission（PR）was reached for 22 cases.The rate of breast-conserving surgery was enhanced from 22.73%to 46.81%（P〈0.05）in the neoadjuvant treatment group. There was no difference in the 5-year overall survival（OS）and disease-free survival（DFS）rate between the two groups（P〉0.05）,but the 5-year OS and DFS of the cases with clinical tumor remission was higher compared to the control group（P〈0.05）. CONCLUSION Neoadjuvant chemotherapy can enhance the rate of breast conservation for Stage Ⅱ breast cancer and may improve the prognosis of the cases with clinical remission.     

RELATIONSHIP BETWEEN EXPRESSIONS OF P38 PROTEIN IN HUMAN BREAST CARCINOMA AND LYMPH NODES METASTASIS

Objective： To detect the change of p38 protein expression and investigate the relationship of p38 and lymph nodes metastasis in human breast carcinomas. Methods： Sixty breast cancer cases were checked by S-P immunohistochemistry technique and 30 breast cancer cases were examined by Western Blot. Results： Immunohistochemical results showed that p38 protein was observed in breast cancer and normal cytoplasm. P-p38 was positive in nucleus in breast cancer. P38 protein expressed positively in 29 out of 38 patients who had lymph nodes metastasis （positive rate 76.3%） and in 9 out of 22 patients who had no lymph nodes metastasis （positive rate 40.9%）. There was a significant difference between these two groups （P〈0.01）. The positive rate of p-p38 in patients who had lymph nodes metastasis was 68.4%, and the positive rate in patients who had no metastasis was 36.4%, and there was a significant difference between these two groups （P〈0.05）. The result of western blot showed that the protein contents of p38 and p-p38 in patients with metastasis was higher than those in patients without metastasis （P〈0.05）. P38 and p-p38 protein expressions had relation with clinical pathological grades in breast cancer, higher in grade Ⅲ than in grade Ⅰ, Ⅱ （P〈0.05）, while had no relation with patients＇ age and tumor size （P〉0.05）. Conclusion： p38 and p-p38 protein expressions had relationship with lymph nodes metastasis and the levels of p38 and p-p38 protein expression in groups with lymph nodes metastasis were higher than in groups without lymph nodes metastasis. P38 and p-p38 protein expressions had relationship with clinical grades and had no relationship with patients＇ age and tumor size.     

Clinicopathological and prognostic differences between mucinous gastric carcinoma and signet-ring cell carcinoma

Objective: To analyze the differences in clinicopathologic characteristics and prognosis between mucinous gastric carcinoma (MGC) and signet-ring cell carcinoma (SRCC). Methods: Clinicopathologic and prognostic data of 1,637 patients with histologically confirmed MGC or SRCC who received surgical operations in the Department of Gastroenterological Surgery, Beijing Cancer Hospital between December 2004 and December 2009 were retrospectively collected and analyzed. The clinicopathological features were analyzed statistically using χ 2 test. Survival was analyzed using the Kaplan-Meier method and multivariate analysis of Cox proportional hazards regression model (backward, stepwise). Results: A total of 181 patients with gastric cancer (74 MGC, 107 SRCC) were included. MGC, when compared with SRCC, was featured by senile patients, stage III and IV, upper third stomach, large tumor size, positive lymph node metastasis, and positive lymphatic vascular invasion (P<0.05). The overall 5-year survival rate showed no difference between the two groups (48.8% vs. 44.8%, P>0.05). However, the survival rate for MGC patients was significant lower than that for SRCC patients when compared among the age <60 years, negative distant metastasis, and tumor localized at upper third stomach (P<0.05). Multivariate Cox proportional hazards models revealed that distant metastasis was a significant independent prognostic indicator in MGC group, and lymph node metastasis and distant metastasis was significant independent prognostic indicators in SRCC group. Conclusions: While compared with SRCC, MGC is associated with a more aggressive tumor biologic behavior. There is no statistically significant difference in distant metastasis, an independent prognostic indicator for both MGC and SRCC, which might be the reason for no significant difference of the overall survival rate between the patients with MGC and SRCC.     

The Use of Postoperative Serum HS-AFP and GGT Ⅱ for Judgment of the Prognosis for Hepatocellular Carcinoma patients

OBJECTIVE To investigate the clinical value of hepatoma-specific alpha -fetoprotein (HS-AFP) and gamma-glutamyltransferaseⅡ(GGTⅡ) for judgment of postoperative prognosis of patients with hepatocellular carcinoma (HCC). METHODS HS-AFP was separated and determined using native polyacrylamide electrophoresis with a discontinuous buffer system and Western blots. GGTⅡwas separated with native polyacrylamide electrophoresis with a discontinuous buffer system and detected by enzyme staining. Forty cases with HCC underwent serial determination of HS-AFP and GGTⅡbefore and after radical excision. The correlations were analyzed between the two indices and survival time. RESULTS In the 40 cases with HCC, before radical excision the positive rates of HS-AFP and GGTⅡwere 57.5% and 67.5% respectively, with the positive rate of combined HS-AFP and GGTⅡreaching 80.0%. After operation, the recurrence and metastasis rate in the groups with positive HS-AFP and GGTⅡwere 90.9% and 58.8% respectively, while in the groups with negative HS-AFP and GGTⅡthe rates were 20.7% and 26.1% respectively. Recurrence and metastasis occurred in all cases with both postoperative positive HS-AFP and GGTⅡbut only in 9.5% of the cases in whom both postoperative HS-AFP and GGTⅡwere negative. Univariate analysis revealed that postoperative HS-AFP and GGTⅡwere related to the prognosis in HCC. CONCLUSION Postoperative serum HS-AFP and GGTⅡare very useful in predicting the prognosis of HCC patients.     

早期宫颈癌(Ⅰb-Ⅱa期)预后相关因素的回顾性分析

Objective: To estimate the impact of parametrial infiltration and lymph node metastasis on clinical outcome in women with early-stage cervical cancer following radical hysterectomy and pelvic lymphadenectomy. Methods: Clinical records and pathologic slides of 532 patients with early-stage cervical cancer (330 Ib and 202 IIa) treated with radical hyster- ectomy and pelvic lymphadenectomy were reviewed. The study group comprised 520 patients with squamous cell carcinoma and 12 patients with adenocarcinoma of the cervix. Median follow-up time was 67 months. The association among the various histopathologic predictors of outcome was determined with analysis. The influence of the predictors on outcome was examined with log rank survival methods and the Cox regression model. Results: FIGO stage, histologic type, tumor size, depth of invasion, parametrial infiltration, lymph node metastasis, and remote metastasis were identified as significantly biologically relevant and therefore were included as candidate predictors in multivariate analysis. In particular, parametrial infiltration and lymph node metastasis were found to be simultaneous predictors of death on multivariate analysis (P < 0.05). After controlling for these two factors, the other variables considered were not statistically significant up to a two-way interaction. Conclusion: Presence of parametrial infiltration and/or lymph node metastasis in women with early-stage cervical cancer is an independent poor prognostic factor. In addition, the relatively poor survival of women with more than one lymph nodes identified with cancer cells.     

大肠癌CXCR4表达与淋巴结转移及预后的关系

Objective： Colorectal cancer is one of the leading causes of cancer related deaths, with recurrence and metastasis as the primary reasons for mortality. New evidence has implicated chemokines as the likely cause. We studied the positive expression of CXCR4 chemokine receptors in colorectal carcinoma and investigated its correlations to clinicpathological characteristics and prognosis. Methods： Tumor tissue specimens of patients with colorectal carcinoma （n = 67） who underwent surgery from January 2003 to December 2004 at the Department of Surgery, Tongji Hospital were collected. CXCR4 expression levels and tumor microvessel density were evaluated by immunohistochemistry. Specimens were immunostained using formalin-fixed, paraffin-embedded tissues. The correlation between the CXCR4 expression and clinicopathological factors was evaluated. Results： In 67 cancer tissue specimens, CXCR4 was positively expressed in 38 cases, positive rate being 56.7%. Positive expression of CXCR4 is associated with an increasing incidence of nodal involvement, higher clinic stage, higher tumor microvessel density and a lower 3-year disease free survival rate as compared to those with negative CXCR4 expression （P 〈 0.05）. Conclusion： Positive CXCR4 expression and high tumor microvessel density are associated with poor prognosis and could be a potential predictive factor for recurrence or metastasis of colorectal cancer patients. So CXCR4 may be a potential target for specific therapeutic interventions in the future.     

Influence of the Number of Lymph Nodes Examined on the Prognosis of Patients with Dukes＇ B and C Colorectal Carcinoma

OBJECTIVE To analyze the influence of the number of lymph nodes examined on the prognosis of Dukes＇ B and C colorectal cancer patients. METHODS The relationship between the clinicopathologic features of 373 patients with Dukes＇ B and C colorectal cancer and number of the lymph nodes examined was retrospectively analyzed. The effect of the different number of nodes examined on the prognosis of the patients was appraised RESULTS The overall mean number of retrieved lymph nodes of the 373 patients with Dukes＇ B and C colorectal cancer was 13.71±9.38. The site and size of the tumor as well as the depth of tumor infiltration were the major reasons which influenced the number of lymph nodes retrieved. The mean number of lymph nodes examined in the colon-cancer patients was 17.51± 12.79, which was significantly more than the 11.09±6.17 （P = 0.000） examined in the rectal-cancer patients. The 5-year survival rate of the patients with Dukes＇ B large intestinal carcinoma, with fewer lymph nodes retrieved （0 to 10）, was only 60.4%, while those with more lymph node retrieved （≥10） had a 5-year survival of 77.5%. So there was a significant difference between the two groups. However the number of lymph nodes examined had no effect on prognosis of the patients with Dukes＇ C large intestinal carcinoma. Separate analysis of the colon and rectal cancers indicated that to improve the 5-year survival rate, the number of retrieved nodes in cases with rectal cancer should be at least 9, and with colon cancer cases at least 13. CONCLUSION In order to guarantee an accuracy of tumor staging for developing a possible postoperative treatment, at least 9 lymph nodes in rectal cancer patients or 13 in colon cancer patients should be harvested.     

Influence of the Number of Lymph Nodes Examined on the Prognosis of Patients with Dukes'''' B and C Colorectal Carcinoma

OBJECTIVE To analyze the influence of the number of lymph nodes examined on the prognosis of Dukes' B and C colorectal cancer patients.METHODS The relationship between the clinicopathologic features of 373 patients with Dukes' B and C colorectal cancer and number of the lymph nodes examined was retrospectively analyzed.The effect of the different number of nodes examined on the prognosis of the patients was appraised RESULTS The overall mean number of retrieved lymph nodes of the 373 patients with Dukes' B and C colorectal cancer was 13.71±9.38.The site and size of the tumor as well as the depth of tumor infiltration were the major reasons which influenced the number of lymph nodes retrieved.The mean number of lymph nodes examined in the colon-cancer patients was 17.51± 12.79,which was significantly more than the 11.09±6.17(P = 0.000)exam-ined in the rectal-cancer patients.The 5-year survival rate of the patients with Dukes' B large intestinal carcinoma,with fewer lymph nodes retrieved(0 to 10),was only 60.4%,while those with more lymph node retrieved(≥10)had a 5-year survival of 77.5%.So there was a significant difference between the two groups.However the number of lymph nodes examined had no effect on prognosis of the patients with Dukes' C large intestinal carcinoma.Separate analysis of the colon and rectal cancers indicated that to improve the 5-year survival rate,the number of retrieved nodes in cases with rectal cancer should be at least 9,and with colon cancer cases at least 13.CONCLUSION In order to guarantee an accuracy of tumor staging for developing a possible postoperative treatment,at least 9 lymph nodes in rec-tal cancer patients or 13 in colon cancer patients should be harvested.     

The Eff ect of the Surgical Margins on the Outcome of Patients with Head and Neck Squamous Cell Carcinoma: Single Institution Experience

Objective To assess the impact of close or positive surgical margins on the outcome,and to determine whether margin status influence the recurrence rate and the overall survival for patients with head and neck cancers. Methods Records from 1996 to 2001 of 413 patients with primary head and neck squamous cell carcinoma(SCC) treated with surgery as the first line treatment were analysed.Of these patients,82 were eligible for the study.Patients were followed up for 5 years. Results Patients with margins between 5-10 mm had 50%recurrence rate(RR),those with surgical margins between 1-5 mm had RR of 59%and those with positive surgical margins had RR of 90%(P=0.004).The 5-year survival rates were 54%,39%and 10%,respectively(P=0.002). Conclusions Unsatisfactory surgical margin is an independent risk factor for recurrence free survival as well as overall survival regardless of the other tumor and patient characteristics.     

INVESTIGATION OF THE RELATIONSHIP BETWEEN CELL PROLIFERATIVE ACTIVITY AND INVASION, METASTASIS AND PROGNOSIS OF GASTRIC CANCER

Objective: To evaluated Bromodeoxyuridine (BrdUrd)/DNA doubleparametric method in detection of gastric carcinoma and to analyze the relationships of cellular BrdUrd labeling indices(LI), G2/M-phase fraction(G2/MPE) and DNA content to the depth of invasion, lymphatic vessel invasion, lymphatic node metastasis, peritoneal dissemination and blood vessel invasion and prognosis.Methods: Fresh tumor samples from 60 cases were examined by BrdUrd/DNA doubleparametric flowcytometry. Propidium iodide(PI) was used as fluorescent probe for total cellular DNA and a monoclonal antibody against BrdUrd incorporated into DNA.Fluorescein-labeled goat anti-mouse antibody was used as second antibody. Results: The values of BrdUrd LI in patients with serosa invasion was significantly higher than those without serosa invasion (P＜0.01); there was statistical significance in 5-year survival rate between the two groups (P＜0.01). Both BrdUrd LI and G2/MPF values were significantly higher in patients with lymphatic vessel invasion than those without invasion (P＜0.01); the patients with lymphatic vascular invasion carried a significantly poor prognosis (P＜0.01). Both BrdUrd LI and G2/MPF values were significantly higher in patients with lymphatic node metastasis than those without metastasis (P＜0.01),there was a statistical significance in 5 years survival between these 2 groups. The incidence of lymphatic node metastasis was significantly higher in aneuploid carcinoma (P＜0.05), and the patients with aneuploid carried a significantly poor prognosis (P＜0.05). Patients with peritoneal dissemination had a significantly worse prognosis (P＜0.01). G2/MPF values were significantly higher in patients with blood vessel invasion than thosew ithout invasion (P＜0.01). Conclusion: Cellular BrdUrd LI,G2/MPF and DNA content are related to depth of invasion,lymphatic vessel invasion, peritoneal dissemination, blood vessel invasion and prognosis of gastric carcinoma.     

Study on the relationship between P-glycoprotein （P-gp） and C-erbB-2 expression in gastric carcinoma

Objective： To understand the relationship between C-erbB-2 and multidrug resistance （MDR） as well as its clinical significance. Methods： P-gp level was detected by flow cytometry and simultaneously to examine the C-erbB-2 expression level by immunohistochemistry assay in the operating samples. Their relationship was analyzed from 59 cases with gastric carcinoma. Results： The P-gp positive expression was 38/59 （64.4%） cases with gastric carcinoma. The C-erbB-2 positive expression was 21/59 （35.6%） cases with gastric carcinoma. From the analysis of the P-gp and C-erbB-2 relationship, which was involving, range in the gastric carcinoma, that involving two or three sites were more than the site one, in the cases with C-erbB-2 negative. Compared this two groups, there was a significant difference （P = 0.026）. When the C-erbB-2 was positive, the P-gp expression had a significant difference （P = 0.04） in comparing the Ⅲ-Ⅳ stage （lymph node metastasis） with Ⅰ-Ⅱ stage （without lymph node metastasis）. The tumor＇s size, differentiation degree, ages and sex were not related to the C-erbB- 2 and P-gp expression. Conclusion： High level of P-gp expression was related to the C-erbB-2 positive expression in clinical Ⅲ-Ⅳ stage patient with gastric carcinoma （lymph node metastasis）. It suggested that the double positive patient might be a poor prognosis. However, when the C-erbB-2 was negative expression, the clinical staging （with lymph node metastasis） was not related to the P-gp expression in gastric carcinoma patients.     

腋淋巴结阴性乳腺癌血管生成与预后相关性研究

】 ObjectiveTo determine the relation of microvessel density (MVD) and the expression of vascular endothelial growth factor (VEGF) with the prognosis of axillary-node-negative breast carcinoma (ANNBC) for searching for new prognostic factors. MethodsEighty specimens resected from patients with ANNBC were investigated by staining with a monoclonal antibody against FVⅢ-RA and polyclonal antibody against VEGF. Correlations between the expression of VEGF,MVD and several of clinicopathologic factors were studied. ResultsThe mean of MVD was 35.99± 20.27 in all patients.The positive rate of VEGF was 36.25％ . Both of them were not correlated with the clinicopathological factors. MVD was significantly higher in VEGF-positive tumors or relapsed or metastatic group than in VEGF-negative tumors or disease-free survival group. Moreover, patients with higher MVD or VEGF positive tumors had lower disease-free survival (DFS) or overall survival (OS) than those with lower MVD or VEGF-negative tumors. When those (45 cases) without adjuvant therapies after surgery were analyzed, the results were the same.But OS of them (35 cases) with adjuvant therapies had no significiant difference between high and low MVD group,and between VEGF positive and negative group. DFS was the same among VEGF positive and negative group. Multivariate analysis indicated that MVD,the expression of VEGF and tumor size were independent prognostic factors in patients with ANNBC. ConclusionsMVD,the expression of VEGF may be good prognostic indicators for patients with ANNBC and adjuvant therapies after surgery or antiangiogenic therapy may be useful to improve the prognosis of patients with high MVD or VEGF-positive tumors.     

Influence of Clinical and Pathologic Parameters on Prognosis of Cervical Carcinoma in China

Objective: To explore the influence of clinical and pathologic parameters on the prognosis of squamous cell carcinoma and adenocarcinoma. Methods: 702 cases of cervical carcinoma were retrospec-tively studied. Cox regression model was informed in multi-variable analysis. Results: The retrospective analysis showed that 630 out of 702 cases of cervical carcinoma were squamous cell carcinoma, cumulative rate 89.4% and 72 case were adenocarcinoma, cumulative rate 10.6% respectively. The 5-year survival rate was lower for patients with adenocarcinoma than for patients with squamous cell carcinoma (58.3% vs 57.3%), but there was no significant difference. Cox regression model showed that the variable into equation for squamous cell carcinoma included tumor grade of differentiation, lymph node metastasis and FIGO stage, but only lymph node metastasis and FIGO stage for adenocarcinoma. Conclusion: FIGO stage and lymph node metastasis was independent parameter evaluating prognosis of cervical carcinoma.     

Observation of the Curative Effect of Mabthera in Combination with the CHOP Regimen in Treating Invasive B-Cell Lymphoma： A Report of 45 Cases

OBJECTIVE To observe the clinical effcacy and toxic effects of Mabthera (rituximab) in combination with the CHOP (R-CHOP) regimen for treating invasive B-cell non-Hodgkin’s lymphoma. METHODS A total of 45 patients with CD20 positive B-cell non-Hodgkin’s lymphoma were randomly divided into the R-CHOP (22 cases) and CHOP groups (23 cases for controls).They received the regimens of Mabthera in combination with CHOP or single CHOP therapy respectively.An appraisement of the curative effect could only be performed following 4 cycles of chemotherapy for the 45 patients.Follow-up was conducted to observe the conditions of survival. RESULTS The rate of complete remission(CR)in the R-CHOP group was 68.2%,with a total effective rate of 81.8%,and in the CHOP group these rates were 34.8% and 78.3% respectively.There was a significant difference in comparing the CR rates between the two groups (P<0.05).The 1,2 and 3-year overall survival (OS) rates of the RCHOP group were 90.9%,81.8% and 77.3%,respectively.In the CHOP group,the OS rates were respectively 91.3%,69.5% and 47.8%.The difference in the 3-year OS between the two groups was significant (P<0.05).The toxic effects of the two groups were mainly a slight and moderate bone marrow depression and a gastrointesinal reaction,with similar tolerable toxic effects in the two groups (P>0.05). Adverse effects related to the Mabthera infusions occurred in 6 cases of the R-CHOP group (27.2%).These effects lessened after symptomatic treatment. CONCLUSION The therapeutic regimen of Mabthera,in combination with CHOP (R-CHOP) has an obvious curative effect for treating invasive B-cell non-Hodgkin's lymphoma,with a favorable tolerance.It is highly recommended as the treatment of choice.     

Analysis of the Clinicopathologic Features and Prognosis in Triple-Negative Breast Cancer

OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identifi ed as triple negative breast cancer,ie defi ned as ER,PR and Her-2 negative.The other group was non-triple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival(DFS) analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4%(109/509) of cases were found to be triple-negative while 78.6%(400/509) were non-triple-negative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors(P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1%(23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a signifi cant difference(P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically signifi cant difference between the 2 groups(P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.     

Male Breast Cancer: 10-Year Experience at Mansoura University Hospital in Egypt

Objective Male breast cancer(MBC) is a rare disease representing less than 1%of all malignancies.The objective of the study is to report clinicopathological characteristics,treatment patterns,and outcomes of MBC in Mansoura University Hospital,Egypt. Methods This retrospective study focused on male breast cancer patients during 10 years(2000-2009).The studied variables were data regarding general characteristics of patients,treatment modalities and survival. Results The series included 37 patients(0.8%of all breast cancer).The median age was 57.7 years(range:26-86 years).The main clinical complaint was a mass beneath the areola in 94.5%of the cases.Most patients had a locally advanced disease.94.5%of tumors were invasive duct carcinomas.The treatment was essentially surgery in 91.8%,followed by adjuvant radiotherapy(in 89.2%), hormonal therapy(in 56.7%) and chemotherapy(in 91.8%).Follow-up period ranged from 6-115 months.Local recurrence occurred in 4 cases and metastasis in 11 cases.The 2-year and 5-year overall survival(OS) rates were 81.6%and 60.5%,respectively.The 2-year and 5-year disease-free survival(DFS) rates were 68.4%,and 52.6%,respectively.OS was not significantly affected by any of the studied parameters.Factors influencing DFS were:T stage(P=0.05),positive lymph nodes(P=0.043),metastasis(P=0.004),and chemotherapy (P=0.046). Conclusions MBC is a rare disease and often diagnosed at a locally advanced stage.The management of male and female breast carcinoma is identical.Future research for better understanding of this disease is needed to improve the management and prognosis of male breast cancer patients.     

STAGE IB, HA AND PROXIMAL IIB, CARCINOMA OF THE UTERINE CERVIX, TREATED BY IRRADIATION ALONE OR IN COMBINATION WITH SURGERY

This is a report of a nonrandomized comparison of treatment results of 139 patients with stage IB, HA and proximal IIB carcinoma of the uterine cervix treated by radiation alone and 113 treated with a combination of radiation and surgery. The five-year tumor free acturial survival for the patients with stage IB either with irradiation alone (RT) or combined with surgery (RS) was approximately 87%. For stage Ⅱ the tumor free actuarial five-year survival 79% with patients of RS, and 76% with RT. In the 113 patients treated with RS there were 18 (16%). In the 139 patients treated by RT there were 18 (13%) recurrences of pelvic, 4 local recurrences, 11 combined with parametrial, and free parametrial recurrences. There was no significant difference in the survival and recurrence rate of the patients treated with either method. Major complications were comparable in both groups (RT approximately 25% and RS approximately 10%), but 2/3 of those complications recovered without sequelae. The most frequent minor     

74例隆突型皮肤纤维肉瘤的治疗与预后分析

Objective： To study treatment and prognostic factor in 74 patients with dermatofibrosarcoma protuberans. Methods： From August 1990 to November 1999, 74 patients with dermatofibrosarcoma protuberans （DFSP） confirmed by pathology were treated in Cancer Hospital of Sun Yat-sen University. 72 cases were given wide excision and 2 cases were given local excision. All of 74 cases, 52 cases had surgical resection alone, and 22 cases had surgical resection combined with radiotherapy. Total dose of radiotherapy was 50-70 Gy. Results： The rate of recurrence was 36.1% for all patients. The 5-year recurrence-free survival （RFS） rate was 66%. The 5-year recurrence-free survival rates for resection alone and combined with radiotherapy were 58% and 90%, respectively （P=-0.0187）. The 5-year recurrence-free survival rates for positive microscopic margins and negative microscopic margins were 57% and 75%, respectively （P=0.0468）. Conclusion： Post-operation radiotherapy is an effective treatment to decrease the recurrence rate for the patients with positive microscope, or the patients without suitable surgical treatment.