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1.
J. Lee S. H. Kang O. K. Noh M. Chun Y.-T. Oh B.-W. Kim S.-W. Kim 《Clinical & translational oncology》2018,20(8):1011-1017
Purpose
We investigated the role of adjuvant concurrent chemoradiation therapy (CCRT) in patients with a microscopically positive resection margin (R1) after curative resection for extrahepatic cholangiocarcinoma (EHCC).Methods/patients
A total of 84 patients treated with curative resection for EHCC were included. Fifty-two patients with negative resection margins did not receive any adjuvant treatments (R0 + S group). The remaining 32 patients with microscopically positive resection margins received either adjuvant CCRT (R1 + CCRT group, n = 19) or adjuvant radiation therapy (RT) alone (R1 + RT group, n = 13).Results
During the median follow-up period of 26 months, the 2-year locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival rates (OS) were: 81.8, 62.6, and 61.5% for R0 + S group; 71.8, 57.8, and 57.9% for R1 + CCRT group; and 16.8, 9.6, and 15.4% for R1 + RT group, respectively. Multivariate analysis revealed that the R1 + CCRT group did not show any significant difference in survival rates compared with the R0 + S group. The R1 + RT group had lower LRRFS [hazard ratio (HR) 3.008; p = 0.044], DFS (HR 2.364; p = 0.022), and OS (HR 2.417; p = 0.011) when compared with the R0 + S and R1 + CCRT group.Conclusions
A lack of significant survival difference between R0 + S group and R1 + CCRT group suggests that adjuvant CCRT ameliorates the negative effect of microscopic positive resection margin. In contrast, adjuvant RT alone is appeared to be inadequate for controlling microscopically residual tumor.2.
Yoshiaki Murakami Kenichiro Uemura Takeshi Sudo Yasushi Hashimoto Naru Kondo Naoya Nakagawa Hayato Sasaki Taijiro Sueda 《Cancer chemotherapy and pharmacology》2013,71(2):419-429
Purpose
Adjuvant chemotherapy is accepted as a standard treatment after surgical resection of pancreatic carcinoma; however, the optimal timing between surgery and initiation of adjuvant chemotherapy has not been reported. The aim of this study was to determine the optimal timing of adjuvant chemotherapy after surgical resection of pancreatic carcinoma.Methods
Records of 104 patients who received adjuvant chemotherapy after curative surgical resection of pancreatic carcinoma were reviewed retrospectively. Patients were grouped according to whether they received initial adjuvant chemotherapy within 20 days after surgery (≦20 days, n = 57) or more than 20 days after surgery (>20 days, n = 47). Relationships between time to initiation of adjuvant chemotherapy, other clinicopathological factors, and survival were analyzed.Results
The rate of postoperative complication was significantly lower than in the ≦20 days group compared with the >20 days group (P = 0.003); no significant difference in other clinicopathological factors was found. Multivariate analysis revealed that time to initiation of adjuvant chemotherapy was an independent prognostic factor of disease-free survival (P = 0.009) and overall survival (P = 0.037). The ≦20 days group had longer 5-year overall survival rates than did the >20 days group (52 vs. 26 %, P = 0.013) as well as longer 5-year disease-free survival rates (53 vs. 22 %, P = 0.007).Conclusions
Adjuvant chemotherapy for patients with resected pancreatic carcinoma should be initiated as soon as possible after surgical resection. Prevention of postoperative complication is needed to enable early initiation. 相似文献3.
Purpose
To evaluate the outcome of radiotherapy (RT) versus radiochemotherapy (RT-CHT) in patients with locally advanced (stage III) inoperable adenocarcinoma of the lung.Patients and methods
146 patients with these characteristics were among 600 patients enrolled into five prospective trials and were treated with either hyperfractionated (Hfx) RT (64.8 and 69.6 Gy using 1.2 Gy bid) alone (n = 33) or with Hfx RT (64.8 and 69.6 Gy using 1.2 Gy bid and 67.6 Gy using 1.3 Gy bid) and concurrent carboplatin–etoposide or paclitaxel–carboplatin (n = 113).Results
The median times and 5-year overall survival (OS), local progression-free survival (LPFS) and the distant metastasis-free survival (DMFS) rates for all 146 patients were 17, 20 and 20 months, respectively, and 15, 26 and 33, respectively. RT-CHT was superior to RT alone in terms of both OS (MST 19 vs. 12 months, respectively, 5-year OS 18 vs. 6 %, respectively; p = 0.003) and LPFS (MTLP 21 vs. 15 months, respectively, 5-year LPFS 28 vs. 0 %; p = 0.06), but not the DMFS (p = 0.43). In all 146 patients, the most frequent acute high-grade toxicity was esophageal, bronchopulmonary and hematological (each 12 %), while the most frequent late high-grade toxicity was bronchopulmonary (4 %) and esophageal (3 %). RT-CHT caused significantly more frequent acute high-grade (>3) esophageal (15 %), and hematological (15 %), while late high-grade toxicity was similar between RT and RT-CHT groups of patients.Conclusion
RT-CHT achieved excellent results (MST 19 months, 5-year survival 18 %) in this patient population accompanied with low toxicity, comparing favorably to results of other similar studies. 相似文献4.
Vinayak S. Rohan Jun-Te Hsu Keng-Hao Liu Chun-Nan Yeh Ta-Sen Yeh Yi-Yin Jan Tsann-Long Hwang 《Journal of gastrointestinal cancer》2013,44(1):89-93
Background
Adenocarcinoma of the body and tail of the pancreas are more often than not inoperable to begin with. Factors predicting the prognosis in the resected tumors of pancreatic body and tail were analyzed.Methods
Between 1989 and 2006, 43 patients with adenocarcinoma of the body and tail of the pancreas underwent resection at Chang Gung Memorial Hospital, Taoyuan, Taiwan. Univariate and multivariate analysis of clinicopathological factors affecting the prognosis were analyzed.Results
Totally, 32 patients were available for the analysis. The median follow-up was 13.6 months (1.5–87.5 months). The median survival time was 14.2 months and the 1-, 3-, and 5-year survival rates were 58.1, 25.8, and 6.5 %, respectively. On univariate analysis, the factors which influenced the survival were tumor size >4 cm (p?=?0.004), lymphatic invasion (p?=?0.001), and positive resection margin (p?=?0.030). On multivariate analysis, only the tumor size and the lymphatic invasion were independent prognostic factors.Conclusion
Even after macroscopic curative resection, the prognosis remains poor for pancreatic body and tail adenocarcinoma. Early diagnosis is the key to achieving long-term survival. Newer effective adjuvant treatment after curative resection is needed to improve the survival 相似文献5.
Makoto Ishitobi Yasuhiro Okumura Reiki Nishimura Katsuhiko Nakatsukasa Masahiko Tanabe Atsushi Yoshida Norikazu Masuda Tadahiko Shien Satoru Tanaka Yoshifumi Komoike Nobuyuki Arima Tetsuya Taguchi Hideo Inaji Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society 《Breast cancer (Tokyo, Japan)》2014,21(6):754-760
Objectives
There are limited data on the outcomes of patients treated with repeat lumpectomy at the time of ipsilateral breast tumor recurrence (IBTR). Especially, the impact of radiotherapy (RT) on a second IBTR is unknown.Methods
We retrospectively analyzed 143 patients from 8 institutions in Japan who underwent repeat lumpectomy after IBTR. The risk factors of a second IBTR were assessed.Results
The median follow-up period was 4.8 years. The 5-year second IBTR-free survival rate was 80.7 %. There was a significant difference in the second IBTR-free survival rate according to RT (p = 0.0003, log-rank test). The 5-year second IBTR-free survival rates for patients who received RT after initial surgery, RT after salvage surgery, and no RT were 78.0, 93.5, and 52.7 %, respectively. Multivariate analysis revealed that RT was a significantly independent predictive factor of second IBTR-free survival.Conclusion
Repeat lumpectomy plus RT is a reasonable option in patients who did not undergo RT at the initial surgery. In contrast, caution is needed when RT is omitted in patients who have undergone repeat lumpectomy. 相似文献6.
Y.-X. Chen Z.-C. Zeng J. Fan Z.-Y. Tang J. Zhou M.-S. Zeng J.-Y. Zhang J. Sun 《Clinical & translational oncology》2013,15(9):732-740
Purpose
To identify independent predictors of survival in patients with lymph node (LN) metastases from hepatocellular carcinoma (HCC) after external beam radiotherapy (EBRT).Methods
There were 191 patients with LN metastases from HCC received EBRT enrolled in the study cohort. EBRT was designed to focus on the LNs and a median dose of 50 Gy (range 40–60 Gy) was delivered. Treatment response was assessed by the WHO response criteria. Factors such as demographic data, tumor characteristics, and treatment modalities were determined before EBRT. Predictors of survival were identified by univariate and multivariate analysis.Results
The median survival was 8.0 months for all patients. Factors including Child-Pugh status (p = 0.009), intrahepatic tumor control (p = 0.015), LN location (p = 0.015), and response to EBRT (p < 0.001) were significant prognostic factors predicting for survival by multivariate analysis. The objective regression rate (ORR), which is the sum of complete and partial response rates, was as high as 79.1 %. As determined by multivariate analysis, the factors of LN location near liver (p = 0.002), smaller LN size (p = 0.021), and higher EBRT dose (p < 0.001) were associated with higher ORR values.Conclusion
This study provides detailed information about survival outcomes and prognostic factors. Child-Pugh B value, uncontrolled intrahepatic tumor, LN location far from liver, and no response to EBRT are the unfavorable independent predictors. 相似文献7.
F. Posch U. Setinek R. M. Flores D. Bernhard G. E. Hannigan M. R. Mueller S. B. Watzka 《Clinical & translational oncology》2014,16(5):455-462
Background
Integrin-linked kinase (ILK) is an intracellular signaling protein critically involved in cellular growth and motility. In non-small cell lung cancer (NSCLC), increased ILK expression has been associated with decreased recurrence-free and overall survival. Recently, ILK has also been detected in the serum of NSCLC patients.Objective
To assess the prognostic impact of preoperative serum ILK (sILK) concentration on overall survival in surgically amenable NSCLC.Patients and methods
Preoperative sILK was quantified by ELISA in 50 newly diagnosed NSCLC patients. After surgery, patients were followed-up for a median interval of 2.5 years.Results
Serum ILK concentrations ranged from 0 to 2.44 ng/ml. Mean sILK was around 2.3 times higher in the 16 patients who died as compared to the 34 patients who survived (1.04 vs. 0.45 ng/ml, p = 0.001). In univariate time-to-event analysis, increased sILK was associated with adverse survival [Hazard ratio (HR): 4.03, 95 % CI: 2.00–8.13, p < 0.001]. This association prevailed after multivariable adjustment for several clinical, demographic, and laboratory parameters (HR: 3.85, 95 % CI: 1.53–9.72, p = 0.004).Conclusions
Serum ILK shows potential as a novel strong and independent prognostic marker for postoperative survival in surgically amenable NSCLC. 相似文献8.
H. J. Park K. Kim J. H. Paik E. K. Chie S. Kim J.-Y. Jang S. W. Kim S.-W. Han D.-Y. Oh S.-A. Im T.-Y. Kim Y.-J. Bang S. W. Ha 《Clinical & translational oncology》2016,18(6):625-631
Purpose
To analyze the expression of c-Met, and to investigate correlations between the expression of c-Met, clinicopathologic variables, and survival in patients undergoing curative surgery followed by adjuvant chemoradiotherapy for extrahepatic bile duct (EHBD) cancer.Methods
Ninety EHBD cancer patients who underwent curative resection followed by adjuvant chemoradiotherapy were enrolled. Expression of c-Met was assessed with immunohistochemical staining on tissue microarray. The correlation between clinicopathologic variables and survival outcomes was evaluated using Kaplan–Meier method and Cox proportional hazard model.Results
On univariate analysis, 66 patients (76.7 %) showed c-Met expression. c-Met expression had a significant impact on 5-year overall survival (OS) (43.0 % in c-Met(+) vs. 25.0 % in c-Met(?), p = 0.0324), but not on loco-regional relapse-free survival or distant metastasis-free survival (DMFS). However, on multivariate analysis incorporating tumor location and nodal involvement, survival difference was not maintained (p = 0.2940). Tumor location was the only independent prognostic factor predicting OS (p = 0.0089). Hilar location tumors, nodal involvement, and poorly differentiated tumors were all identified as independent prognostic factors predicting inferior DMFS (p = 0.0030, 0.0013, and 0.0037, respectively).Conclusions
This study showed that c-Met expression was not associated with survival outcomes in EHBD cancer patients undergoing curative resection followed by adjuvant chemoradiotherapy. Further studies are needed to fully elucidate the prognostic value of c-Met expression in these patients.9.
Motoo Nagane Keiichi Kobayashi Masaki Tanaka Kazuhiro Tsuchiya Yukiko Shishido-Hara Saki Shimizu Yoshiaki Shiokawa 《International journal of clinical oncology / Japan Society of Clinical Oncology》2014,19(1):16-23
Background
Recurrent glioblastoma after initial radiotherapy plus concomitant and adjuvant temozolomide is problematic. Here, patients with temozolomide-refractory high-grade gliomas were treated with bevacizumab (BV) and evaluated using apparent diffusion coefficient (ADC) for response.Methods
Nine post-temozolomide recurrent or progressive high-grade glioma patients (seven with glioblastoma and two with anaplastic astrocytoma) were treated with BV monotherapy. Average age was 57 years (range, 22–78), median Karnofsky Performance Scale (KPS) was 70 (30–80) and median BV line number was 2 (2–5). Two had additional stereotactic radiotherapy within 6 months prior to BV. Magnetic resonance (MR) imaging after BV therapy was performed within 2 weeks with calculation of mean ADC (mADC) values of enhancing tumor contours.Results
Post-BV treatment MR imaging showed decreased tumor volumes in eight of nine cases (88.9 %). Partial response was obtained in four cases (44.4 %), four cases had stable disease, and one had progressive disease. Of 15 evaluable enhancing lesions, 11 shrank and four did not. Pretreatment mADC values were above 1100 (10?6 mm2/s) in all responding tumors, while all non-responding lesions scored below 1100 (p = 0.001). mADC decreased after the first BV treatment in all lesions except one. KPS improved in four cases (44.4 %). Median progression-free survival and overall survival for those having all lesions with high mADC (>1100) were significantly longer than those with a low mADC (<1100) lesion (p = 0.018 and 0.046, respectively).Conclusions
Bevacizumab monotherapy is effective in patients with temozolomide-refractory recurrent gliomas and tumor mean ADC value can be a useful marker for prediction of BV response and survival. 相似文献10.
Katsushi Takebayashi Eiji Mekata Hiromichi Sonoda Tomoharu Shimizu Yoshihiro Endo Tohru Tani 《Cancer chemotherapy and pharmacology》2013,72(1):217-222
Purpose
We retrospectively evaluated the clinical efficacy and feasibility of a collagen gel droplet-embedded culture drug sensitivity test (CD-DST) to guide therapy for patients with stage IV colorectal cancer (CRC).Methods
We investigated 38 patients with stage IV CRC. All patients were younger than 85 years and had untreated evaluable metastatic lesions. The primary tumors were surgically resected, and the tissue samples were investigated by CD-DST. Patients treated with in vitro sensitive drugs were defined as Group A (n = 14), while those treated with in vitro non-sensitive drugs were defined as Group B (n = 24). We evaluated response rate (RR), progression-free survival (PFS), and overall survival (OS).Results
RR was 85.71 % in Group A and 41.67 % in Group B (p = 0.0079). The median PFS was 696.5 days in Group A and 297.5 days in Group B (p = 0.0326). The median OS was 1,023.4 days in Group A and 518.5 days in Group B (p = 0.0061).Conclusions
The CD-DST can define chemoresistant and chemosensitive tumors. The use of CD-DST might be one of the tools to supplement informed consent prior to initiation of therapy. 相似文献11.
12.
Harrison X. Bai Sabin B. Motwani Susan A. Higgins Bruce G. Haffty Lynn D. Wilson Donald R. Lannin Suzanne B. Evans Meena S. Moran 《International journal of clinical oncology / Japan Society of Clinical Oncology》2014,19(3):460-466
Background
For DCIS patients eligible for breast conservation treatment (BCT), it remains unclear whether presenting with physical signs/symptoms (Phys) confers a worse long-term prognosis compared to mammographically detected DCIS (Mam).Methods
We collected data on 669 DCIS patients treated with BCT from 1974 to 2007 of whom 80 were identified as category “Phys” and 589 were in category “Mam.”Results
Treatment parameters (i.e., the RT dose delivered, boost, rates of stereotactic biopsy, re-excision, node dissection) did not differ significantly between the two cohorts (p = NS). At a 60-month median follow-up, significant associations included younger age at presentation (p < 0.001), non-white race (p = 0.041), larger tumor size (p = 0.002), more 1°/2° papillary histology (1°, p = 0.001; 2°, p = 0.005) for the Phys cohort. As expected, mammograms were more likely to show mass/nodules/asymmetrical densities and less likely to show microcalcifications for the Phys versus Mam group (p < 0.0001). There were no differences in family history, multifocality, grade, necrosis, or residual disease at re-excision, nodal involvement, status of margins, or ER/PR/HER-2 between the cohorts. The local relapse-free survival was similar at 5 years (100 vs. 96.9 %, p = 0.116) and 10 years (96.2 vs. 96.2 %, p = 0.906), with no significant overall survival difference at 10 years (97.5 vs. 95.9 %, p = 0.364) between the Phys and Mam patients, respectively. On multivariate analysis, presentation was not an independent predictor of local relapse-free survival or overall survival when accounting for age, race, tumor size, mammogram appearance, and adjuvant hormone treatment.Conclusions
Our findings suggest that although some clinicopathological differences exist between DCIS patients presenting with physical signs/symptoms compared with those presenting with mammographically detected disease, long-term outcomes are similar for patients appropriately selected for BCT. 相似文献13.
Tomoko Iehara Minoru Hamazaki Tatsuro Tajiri Yoshifumi Kawano Michio Kaneko Hitoshi Ikeda Hajime Hosoi Tohru Sugimoto Tadashi Sawada 《International journal of clinical oncology / Japan Society of Clinical Oncology》2013,18(3):389-395
Background
The aim of this study was to evaluate the effectiveness of post-surgical chemotherapy for infants with localized neuroblastoma without MYCN amplification (MNA), and determine whether risk classification using MNA is reasonable.Methods
Four hundred and fourteen eligible patients were registered between 1998 and 2004. Resectable patients in stage 1 and 2A/2B were treated by surgical resection only. Unresectable patients in stage 3 without MNA received either 6 cycles of regimen A or 3 cycles of regimen A plus 3 cycles of regimen C2; regimen A consisted of low doses of cyclophosphamide and vincristine and regimen C consisted of cyclophosphamide, vincristine and pirarubicin before surgical resection. The resectable and unresectable patients were randomly selected to receive post-surgical chemotherapy. The patients with MNA received intensive chemotherapy regimen D2, consisting of cyclophosphamide, vincristine, pirarubicin and cisplatin, and some of them received high-dose chemotherapy with stem cell transplantation.Results
The 5-year event-free survival (5-EFS) rates of stage 1 and 2A/2B patients without MNA were 97.2 and 89.0% respectively (p = 0.02). A total of 31 patients in stage 3 without MNA received post-surgical chemotherapy, and 30 patients did not. The 5-EFS rates of these two groups (96.0 and 96.2%, respectively) were not significantly different (p = 0.869). The 5-EFS rate for localized patients with MNA (n = 6) was 50.0%, and that of patients without MNA was 95.0% (p < 0.001).Conclusion
Post-surgical chemotherapy was therefore unnecessary for localized patients without MNA. This treatment strategy using MNA is considered to be appropriate in infants. 相似文献14.
Hiroo Wada Manabu Shiozawa Nobuhiro Sugano Soichiro Morinaga Yasushi Rino Munetaka Masuda Makoto Akaike Yohei Miyagi 《International journal of clinical oncology / Japan Society of Clinical Oncology》2013,18(6):1025-1031
Background
The management of T1 colorectal cancer after local resection is controversial. Regional lymph node metastasis often occurs, requiring subsequent colonic resection. The aim of this study was to reevaluate the risk factors of nodal metastasis of T1 colorectal cancer, especially to examine lymphatic vessel invasion in serially prepared hematoxylin and eosin sections and D2-40 immunostained sections to determine which is a better indicator of lymph node metastasis of T1 colorectal cancer.Methods
The study investigated 120 patients who underwent bowel resection and were histologically diagnosed to have T1 colorectal cancer in Kanagawa Cancer Center Hospital from 1995 to 2005. Serially prepared paraffin sections were stained with hematoxylin and eosin, or immunostained with D2-40 antibody or von Willebrand factor, and reevaluated for lymphatic vessel invasion and other risk factors, including venous invasion, histological grade, depth of submucosal invasion, and budding.Results
Lymphatic invasion diagnosed with either hematoxylin and eosin staining (p = 0.022), or D2-40 immunostaining (p = 0.001), and budding (p = 0.013) were significant risk factors for lymph node metastasis in the univariate analysis. Venous involvement, histological grade, or depth of submucosal invasion was not significant. The multivariate logistic regression analysis for the three risk factors found lymphatic invasion diagnosed with D2-40 as an independent risk factor (odds ratio 6.048, p = 0.018, CI 1.360–26.89). The sensitivity, specificity, positive predictive value, and negative predictive value were 58 %, 88 %, 35 %, and 95 %, respectively.Conclusions
Lymphatic vessel invasion diagnosed with D2-40 was a better indicator to evaluate the risk for lymph node metastasis by T1 colorectal cancer. 相似文献15.
E. Visser P.S.N. van Rossum A.G. Leeftink S. Siesling R. van Hillegersberg J.P. Ruurda 《European journal of surgical oncology》2017,43(2):461-470
Background
The aim of this study was to determine whether the waiting time from diagnosis to treatment with curative intent for esophageal cancer impacts oncologic outcomes.Patients and methods
All patients treated by esophagectomy for esophageal carcinoma in 2005–2013 were identified from the Netherlands Cancer Registry. Patients who underwent multimodality treatment and patients treated with surgery only were analyzed separately. Multivariable logistic regression analyses were performed to evaluate the impact of diagnosis-to-treatment waiting time on pT-status, pN-status, and R0 resection rates. Cox regression was applied to estimate the influence of waiting time on overall survival. Analyses were performed with the original scale and in three categorized groups of waiting time (≤5 weeks, 5–8 weeks, and >8 weeks) based on guidelines and previous studies.Results
Of 3839 patients, 2589 underwent multimodality treatment and 1250 were treated with surgery only. In both groups, pT-status, pN-status, and R0 resection rates were not significantly influenced by waiting time (p-values >0.05). Also, waiting time was not significantly associated with overall survival in the multimodality treatment group (5–8 weeks vs. ≤5 weeks, hazard ratio [HR] 1.12, p = 0.171; and >8 weeks vs. ≤5 weeks, HR 1.21, p = 0.167), nor in the surgery only group (5–8 weeks vs. ≤5 weeks, HR 0.92, p = 0.432; and >8 weeks vs. ≤5 weeks, HR 1.00, p = 0.973).Conclusion
This large population-based cohort study demonstrates that longer waiting time from diagnosis to treatment in patients treated for esophageal cancer with curative intent does not negatively impact pT-status, pN-status, R0 resection rates, and overall survival. 相似文献16.
Yoon-Koo Kang Jeong Hwan Yook Heung-Moon Chang Min-Hee Ryu Changhoon Yoo Dae Young Zang Jae-Lyun Lee Tae Won Kim Dae Hyun Yang Se Jin Jang Young Soo Park Young Jack Lee Hwoon-Yong Jung Jin-Ho Kim Byung Sik Kim 《Cancer chemotherapy and pharmacology》2014,73(1):139-149
Purpose
To improve the efficacy of adjuvant chemotherapy with mitomycin-C and fluoropyrimidine (Mf) in gastric cancer, we designed a new regimen (iceMFP) and investigated in a phase III study.Methods
We randomly assigned 640 patients with resectable and macroscopically recognizable serosa-invading gastric cancer to Mf or iceMFP group during operation. The Mf consisted of intravenous mitomycin-C (20 mg/m2) at 3–6 weeks after surgery and oral doxifluridine (460–600 mg/m2/day) starting 4 weeks after the administration of mitomycin-C and continuing for 3 months. The iceMFP consisted of intraoperative intraperitoneal cisplatin (100 mg), intravenous mitomycin-C (15 mg/m2) on postoperative day 1, followed by oral doxifluridine for 12 months, and six monthly intravenous cisplatin (60 mg/m2). The primary endpoint was 3-year recurrence-free survival (RFS).Results
A total of 521 patients (258 in Mf, 263 in iceMFP) were eligible for analysis after excluding patients with stage I disease, distant metastasis, or R1 resection. With a median follow-up of 3.5 years, the iceMFP group had a higher RFS (hazard ratio [HR] 0.70; 95 % confidence interval [CI] 0.54–0.90; p = 0.006; 3-year RFS 60 % vs. 50 %) and overall survival (HR 0.71; 95 % CI 0.53–0.95; p = 0.02; 3-year overall survival, 71 vs. 60 %) compared with the Mf group. This was confirmed at extension analysis after a median 6.6 years of follow-up. Both regimens were well tolerated with no differences in surgical complications.Conclusion
The efficacy of adjuvant Mf was significantly improved by the additional therapeutic strategies of iceMFP. Considering negative results of AMC0201, these suggest that early initiation of chemotherapy and/or intraperitoneal cisplatin played a distinct role in the improved efficacy. 相似文献17.
Tomoya Yokota Tetsuro Onitsuka Kimihide Kusafuka Hirofumi Ogawa Yusuke Onozawa Masahiro Nakagawa Yoshiyuki Iida Tomoyuki Kamijo Tetsuo Nishimura Takashi Nakajima Narikazu Boku Hirofumi Yasui 《International journal of clinical oncology / Japan Society of Clinical Oncology》2014,19(1):38-44
Background
High-risk factors for recurrence of head and neck squamous cell carcinoma after surgical resection include involvement of ≥2 regional lymph nodes, extracapsular spread, and microscopic involvement of resected mucosal margins. Adjuvant chemoradiotherapy is thought to improve postoperative locoregional control and survival. In this paper, we evaluate the efficacy of adjuvant therapy for high-risk oropharyngeal squamous cell carcinoma (OPSCC) (i.e., with ≥2 lymph nodes, positive extracapsular spread, or positive margins).Methods
This is a retrospective analysis of 45 high-risk OPSCC patients who underwent surgery without adjuvant therapy (n = 19), with radiotherapy (n = 17), or with chemoradiotherapy (n = 9).Results
The median follow-up period was 41.0 months. Radiotherapy patients showed a trend toward longer overall survival than patients without adjuvant therapy [hazard ratio (HR) = 0.32, p = 0.176]. However, overall survival for the chemoradiotherapy group seemed to be the same as that for the no adjuvant therapy group (HR = 0.79, p = 0.779). Multivariate analysis found that the relative risk of recurrence for patients without adjuvant therapy compared with any adjuvant therapy was 3.02 (p = 0.101). The relative recurrence risk in radiotherapy patients was 0.95 compared with that in chemoradiotherapy patients (p = 0.971). However, pathological T-stage was significantly associated with disease-free survival for high-risk OPSCC.Conclusions
Although the current study uses data from a small retrospective sample of patients, our results suggest that the addition of chemotherapy to radiotherapy may not be necessary as an adjuvant therapy for all high-risk OPSCC. A novel prognostic factor, such as pathological T-stage, should be considered for selecting those patients with high-risk OPSCC who would benefit from adjuvant therapy. 相似文献18.
Akiko Kawano Chikako Shimizu Kenji Hashimoto Takayuki Kinoshita Hitoshi Tsuda Hirofumi Fujii Yasuhiro Fujiwara 《Breast cancer (Tokyo, Japan)》2013,20(2):145-151
Background
The purpose of this work was identify potential prognostic factors for survival in patients with primary metastatic hormone receptor-positive breast cancer undergoing endocrine therapy (ET) as first-line treatment.Methods
We investigated the clinical and pathological characteristics of 69 newly diagnosed stage IV hormone receptor-positive breast cancer patients undergoing ET between 1999 and 2009, and correlated these factors with disease progression and overall survival.Results
Multivariate regression analysis revealed that progesterone receptor (PgR) positivity (hazard ratio (HR) 0.248; p = 0.001) and clinical benefits of first-line ET (HR 0.386; p = 0.008) were significant prognostic factors for survival. When first-line ET was not effective, patients for whom second-line ET was effective survived significantly longer than those for whom second-line ET was not effective (median survival time, 45.3 vs. 25.8 months; p = 0.0411).Conclusions
PgR positivity and clinical benefits of first-line ET were independent prognostic factors for patients with hormone receptor-positive stage IV breast cancer. Moreover, the benefits of second-line ET in patients with a tumor resistant to first-line ET suggests the existence of drug-specific resistance to ET. 相似文献19.
Daisuke Kuroda Hiroshi Sawayama Junji Kurashige Masaaki Iwatsuki Tsugio Eto Ryuma Tokunaga Yuki Kitano Kensuke Yamamura Mayuko Ouchi Kenichi Nakamura Yoshifumi Baba Yasuo Sakamoto Yoichi Yamashita Naoya Yoshida Akira Chikamoto Hideo Baba 《Gastric cancer》2018,21(2):204-212
Background
Controlling Nutritional Status (CONUT), as calculated from serum albumin, total cholesterol concentration, and total lymphocyte count, was previously shown to be useful for nutritional assessment. The current study investigated the potential use of CONUT as a prognostic marker in gastric cancer patients after curative resection.Methods
Preoperative CONUT was retrospectively calculated in 416 gastric cancer patients who underwent curative resection at Kumamoto University Hospital from 2005 to 2014. The patients were divided into two groups: CONUT-high (≥4) and CONUT-low (≤3), according to time-dependent receiver operating characteristic (ROC) analysis. The associations of CONUT with clinicopathological factors and survival were evaluated.Results
CONUT-high patients were significantly older (p < 0.001) and had a lower body mass index (p = 0.019), deeper invasion (p < 0.001), higher serum carcinoembryonic antigen (p = 0.037), and higher serum carbohydrate antigen 19-9 (p = 0.007) compared with CONUT-low patients. CONUT-high patients had significantly poorer overall survival (OS) compared with CONUT-low patients according to univariate and multivariate analyses (hazard ratio: 5.09, 95% confidence interval 3.12–8.30, p < 0.001). In time-dependent ROC analysis, CONUT had a higher area under the ROC curve (AUC) for the prediction of 5-year OS than the neutrophil lymphocyte ratio, the Modified Glasgow Prognostic Score, or pStage. When the time-dependent AUC curve was used to predict OS, CONUT tended to maintain its predictive accuracy for long-term survival at a significantly higher level for an extended period after surgery when compared with the other markers tested.Conclusions
CONUT is useful for not only estimating nutritional status but also for predicting long-term OS in gastric cancer patients after curative resection.20.
Tatsuo Hata Naoaki Sakata Katsuyoshi Kudoh Chikashi Shibata Michiaki Unno 《Gastric cancer》2014,17(3):578-587