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1.
Purpose
Many studies have shown that hospital volume is significantly associated with short- and long-term outcomes in various diseases, including cancer. However, there have been no reports discussing the relationship between hospital volume and familial adenomatous polyposis (FAP). This study aimed to clarify whether hospital volume affects short- and long-term outcomes in FAP patients.Methods
We established a retrospectively collected database of FAP patients who underwent initial surgical treatment at 23 Japanese institutions during 2000–2012. Factors associated with short- and long-term outcomes were analyzed.Results
The study cohort included 303 FAP patients. These patients were classified into tertile categories according to hospital volume: low (n = 31), middle (n = 72), and high volume (n = 200). The proportion of only adenoma/stage 0 was comparable among tertile categories. The adoption of operative procedure significantly differed among tertile categories; specifically, high-volume institutions preferred handsewn ileal pouch-anal anastomosis without diverting ileostomy (P < 0.001 and < 0.001, respectively). Nevertheless, the frequency of complications with Clavien-Dindo classification grade ≥ 3 was not significantly different among tertile categories. Functional results were acceptable in every category. Wexner scores were significantly lower in high-volume compared to low-volume institutions (P = 0.02). Multivariate analyses showed that UICC stage and hospital volume were significantly associated with overall survival (P = 0.04 and 0.03, respectively).Conclusions
Hospital volume was significantly associated with short- and long-term outcomes in FAP patients.2.
Soichiro Ishihara Kensuke Otani Koji Yasuda Takeshi Nishikawa Toshiaki Tanaka Junichiro Tanaka Tomomichi Kiyomatsu Kazushige Kawai Keisuke Hata Hioaki Nozawa Shinsuke Kazama Hironori Yamaguchi Eiji Sunami Joji Kitayama Kenichi Sugihara Toshiaki Watanabe 《International journal of colorectal disease》2016,31(6):1149-1155
Purpose
Colon cancers in male and female patients are suggested to be oncologically different. The aim of this study is to elucidate the prognostic impact of lymph node dissection (LND) in male and female colon cancer patients.Methods
A total of 5941 stage I-III colon cancer patients who were curatively operated on during the period from 1997 to 2007 were retrospectively studied. Cancer-specific survival (CSS) was individually compared between for male and female patients treated with D3, D2, and D1 LND. Background differences of the patients were matched using propensity scores.Results
D3, D2, and D1 LND were performed in 3756 (63 %), 1707 (29 %), and 478 (8 %), respectively, and more extensive LND was indicated for younger patients and more advanced disease. D2 LND was significantly associated with decreased cancer-specific mortality compared to D1 LND in male patients (HR 0.54, 95 % CI 0.32–0.89, p?=?0.04), but not in female patients. D3 LND did not correlate to an improved prognosis compared to D2 LND both in male and female patients.Conclusions
D2 LND was associated with an improved CSS in male, but not female colon cancer patients, compared to D1 LND. This suggested that colon cancer in male and female patients might be oncologically different, and that the prognostic impact of the extent of surgical intervention for colon cancer might therefore be different between sexes.3.
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A nationwide survey of hypoplastic myelodysplastic syndrome (a multicenter retrospective study) 下载免费PDF全文
Takashi Kobayashi Yasuhito Nannya Motoshi Ichikawa Kenji Oritani Yuzuru Kanakura Akihiro Tomita Hitoshi Kiyoi Masayoshi Kobune Junji Kato Hiroshi Kawabata Motohiro Shindo Yoshihiro Torimoto Yuji Yonemura Nobuyoshi Hanaoka Hideki Nakakuma Daisuke Hasegawa Atsushi Manabe Naohito Fujishima Nobuharu Fujii Mitsune Tanimoto Yasuyoshi Morita Akira Matsuda Atsushi Fujieda Naoyuki Katayama Haruhiko Ohashi Hirokazu Nagai Yoshiki Terada Masayuki Hino Ken Sato Naoshi Obara Shigeru Chiba Kensuke Usuki Masatsugu Ohta Osamu Imataki Makiko Uemura Tomoiku Takaku Norio Komatsu Akira Kitanaka Kazuya Shimoda Kenichiro Watanabe Kaoru Tohyama Akifumi Takaori‐Kondo Hideo Harigae Shunya Arai Yasushi Miyazaki Keiya Ozawa Mineo Kurokawa for National Research Group on Idiopathic Bone Marrow Failure Syndromes 《American journal of hematology》2017,92(12):1324-1332
Hypoplastic myelodysplastic syndrome (hMDS) is a distinct entity with bone marrow (BM) hypocellularity and the risk of death from BM failure (BMF). To elucidate the characteristics of hMDS, the data of 129 patients diagnosed between April 2003 and March 2012 were collected from 20 institutions and the central review team of the National Research Group on Idiopathic Bone Marrow Failure Syndromes, and compared with 115 non‐hMDS patients. More RA and fewer CMMoL and RAEB‐t in French‐American‐British (FAB) and more RCUD and MDS‐U and fewer RCMD in World Health Organization (WHO) classifications were found in hMDS than non‐hMDS with significant differences. The overall survival (OS) and AML progression‐free survival (AML‐PFS) of hMDS were higher than those of non‐hMDS, especially in patients at age ≥50 and of lower risk in Revised International Prognostic Scoring System (IPSS‐R). In competing risks analysis, hMDS exhibited decreased risk of AML‐progression in lower IPSS or IPSS‐R risk patients, and higher risk of death from BMF in patients at age ≥50. Poor performance status (PS ≥2) and high karyotype risks in IPSS‐R (high and very high) were significant risk factors of death and AML‐progression in Cox proportional hazards analysis. 相似文献
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Gregoire Desolneux Pascal Burtin Emilie Lermite Roberto Bergamaschi Antoine Hamy Jean Pierre Arnaud 《International journal of colorectal disease》2010,25(7):829-834
Purpose
There is a need to identify a subgroup of high-risk patients with node-negative colorectal cancer who have a poor long-term prognosis and may benefit from adjuvant therapies. The aim of this study was to evaluate the prognostic impact of clinical and pathological parameters in a retrospective study from a prospective, continuous database of homogenously treated patients. 相似文献6.
Shinto Eiji Ike Hideyuki Hida Jin-ichi Kobayashi Hirotoshi Hashiguchi Yojiro Kajiwara Yoshiki Hase Kazuo Ueno Hideki Sugihara Kenichi 《Journal of gastroenterology》2019,54(7):597-607
Journal of Gastroenterology - The prognostic significance of lymph node ratio (LNR) is not constant among studies. Exploration of appropriate location-specific cutoffs might be necessary because... 相似文献
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Po-Huang Chen Yi-Ying Wu Cho-Hao Lee Chi-Hsiang Chung Yu-Guang Chen Tzu-Chuan Huang Ren-Hua Yeh Ping-Ying Chang Ming-Shen Dai Shiue-Wei Lai Ching-Liang Ho Jia-Hong Chen Yeu-Chin Chen Je-Ming Hu Sung-Sen Yang Wu-Chien Chien 《Medicine》2021,100(18)
We conducted a population-based cohort study enrolling patients with Stage II and III colon cancer receiving postoperative adjuvant chemotherapy with uracil and tegafur (UFT) or fluorouracil (5-FU) from the Taiwan National Health Insurance Research Database from 2000 to 2015. The outcomes of the current study were disease-free survival (DFS) and overall survival (OS). Hazard ratios (HRs) were calculated by multivariate Cox proportional hazard regression models. We compared our effectiveness results from the literature by meta-analysis, which provided the best evidence. Severe adverse events were compared in meta-analysis of reported clinical trials. In the nationwide cohort study, UFT (14,486 patients) showed DFS similar to postoperative adjuvant chemotherapy (adjusted HR 1.037; 95% confidence interval [CI] 0.954–1.126; P = .397) and OS (adjusted HR 0.964; 95% CI 0.891–1.041; P = .349) compared with the 5-FU (866 patients). Our meta-analysis confirmed the similarity of effectiveness and found the incidence of leucopaenia was statistically significantly reduced in UFT (risk ratio 0.12; 95% CI 0.02–0.67; I2 = 0%). Through our analysis, we have confirmed that UFT is a well-tolerated adjuvant therapy choice, and has similar treatment efficacy as 5-FU in terms of DFS and OS in patients with Stage II and III colon cancer. 相似文献
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《British journal of haematology》2018,180(6):831-839
We report a multicentre retrospective study that analysed clinical characteristics and outcomes in 117 patients with primary plasma cell leukaemia (pPCL) treated at the participating institutions between January 2006 and December 2016. The median age at the time of pPCL diagnosis was 61 years. Ninety‐eight patients were treated with novel agents, with an overall response rate of 78%. Fifty‐five patients (64%) patients underwent upfront autologous stem cell transplantation (ASCT). The median follow‐up time was 50 months (95% confidence interval [CI] 33; 76), with a median overall survival (OS) for the entire group of 23 months (95% CI 15; 34). The median OS time in patients who underwent upfront ASCT was 35 months (95% CI 24·3; 46) as compared to 13 months (95% CI 6·3; 35·8) in patients who did not receive ASCT (P = 0·001). Multivariate analyses identified age ≥60 years, platelet count ≤100 × 109/l and peripheral blood plasma cell count ≥20 × 109/l as independent predictors of worse survival. The median OS in patients with 0, 1 or 2–3 of these risk factors was 46, 27 and 12 months, respectively (P < 0·001). Our findings support the use of novel agents and ASCT as frontline treatment in patients with pPCL. The constructed prognostic score should be independently validated. 相似文献
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Qian Cheng Lyu Xiao Zhu Hai-Dong Zhang Yi Du Rui-Jie Li Rui Teng Gao-Jun Gu Jian-Ping 《Journal of thrombosis and thrombolysis》2021,51(4):1094-1100
Journal of Thrombosis and Thrombolysis - Although mechanical thrombectomy is a powerful predictor of stroke outcome, it induces vessel wall injury in the acute phase. This study aimed to analyze... 相似文献
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Simorre B Quéré I Berrut G Chassé JF Bellet H Kamoun P le Hello C Saudubray JM Janbon C 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2002,23(3):267-272
PURPOSE: Arterial or venous thromboses are frequent in patients with homocystinuria. Because severe homocystinuria is rare, prevalence of thrombosis, especially in France, is still unknown. METHODS: Review of the clinical outcome of 37 patients with homocystinuria due to cystathionine-cystathionine beta-synthase deficiency (34) and 5,10-methylenetetrahydrofolate reductase (three) lead us to describe vascular complications occurring in 12 (32%) of them. RESULTS: Venous thromboembolism is the earlier and the most frequent one and is mainly found in untreated late-diagnosed cases. Under specific treatment of homocystinuria, thromboses are rare and always a complication of surgery associated with high thromboembolic risk. Association with factor V Leiden increased the risk of venous thrombosis. 相似文献
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Ryu JK Lee JK Kim YT Lee DK Seo DW Lee KT Kim HG Kim JS Lee HS Kim TN Rho MH Moon JH Lee J Choi HS Lee WJ Yoo BM Yoon YB;Korean Multicenter Study Group on Chronic Pancreatitis 《Digestion》2005,72(4):207-211
BACKGROUND/AIMS: No reliable nationwide clinical data about chronic pancreatitis (CP) was available in Korea. The etiology and clinical features of CP were investigated using a multicenter nationwide study. METHODS: 814 cases of CP were enrolled retrospectively over the past 4 years at 13 hospitals. The following data were obtained from all patients: etiology, symptoms, complications, and surgery. RESULT: Alcohol (64.3%) was the major cause of CP and idiopathic CP (20.8%) was the second most common form. Mean patient age was 50.6 years and the male:female ratio was 6:1 (24:1 for alcoholic CP vs. 2:1 in idiopathic CP, p < 0.001). Diabetes (31.6%), pseudocysts (28.4%), biliary stricture (13.9%), and pancreatic ascites (6.6%) were the main complications. Of these, diabetes (35 vs. 26%) and pseudocyst (33.7 vs. 21.9%) were more frequent in alcoholic than in idiopathic CP. Pancreatic cancer developed in 25 patients (3.1%) during follow-up and their mean age was 59.1 years. CONCLUSIONS: In Korea, alcohol is the most common etiology of CP. Moreover, diabetes and pseudocysts are frequent complications, especially in alcoholic CP, and pancreatic cancer development is not infrequent. 相似文献
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Type 2 diabetes and the risk of colorectal polyps: A retrospective nationwide population-based study
The incidence rates of type 2 diabetes mellitus (T2DM) and colorectal polyps have been increasing over the last decades. However, direct associations between T2DM and colorectal polyps have not been extensively reported. We will explore the relationship between T2DM and colorectal polyps.In the retrospective study, we classified DM and NonDM groups (control) from 993,516 people in Taiwan nationwide population insurance database from the period of 2000 to 2013. We collected data on income and comorbidities through the international classification of diseases, ninth revision—clinical modification (ICD-9-CM) codes.The T2DM group had a higher incidence rate of colorectal polyps (31.97%, 95% confidence interval [CI] = 30.97–33.28) than the control group (25.9%, 95% CI = 25.1–26.72), and the crude incidence ratio was 1.235 (95% CI = 1.174–1.300). In 13 years of follow-up (2000–2013), T2DM was linked to a significantly higher cumulative probability of colorectal polyps (log-rank test: P = .0001).Patients with T2DM had a 1.23-fold higher risk of new colorectal polyps than control patients in 13 years of follow-up. We explain the T2DM increases incidence for colorectal polyps in long term follow-up. 相似文献
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Tomohiro Aoki Koji Izutsu Ritsuro Suzuki Chiaki Nakaseko Hiroshi Arima Kazuyuki Shimada Akihiro Tomita Makoto Sasaki Jun Takizawa Kinuko Mitani Tadahiko Igarashi Yoshinobu Maeda Noriko Fukuhara Fumihiro Ishida Nozomi Niitsu Ken Ohmachi Hirotaka Takasaki Naoya Nakamura Tomohiro Kinoshita Shigeo Nakamura Michinori Ogura 《Haematologica》2014,99(12):1817-1825
The prognosis of patients with primary mediastinal large B-cell lymphoma has improved over recent years. However, the optimal treatment strategy including the role of radiotherapy remains unknown. We retrospectively analyzed the clinical outcomes of 345 patients with newly diagnosed primary mediastinal large B-cell lymphoma in Japan. With a median follow up of 48 months, the overall survival at four years for patients treated with R-CHOP (n=187), CHOP (n=44), DA-EPOCH-R (n=9), 2nd- or 3rd-generation regimens, and chemotherapy followed by autologous stem cell transplantation were 90%, 67%, 100%, 91% and 92%, respectively. Focusing on patients treated with R-CHOP, a higher International Prognostic Index score and the presence of pleural or pericardial effusion were identified as adverse prognostic factors for overall survival in patients treated with R-CHOP without consolidative radiotherapy (IPI: hazard ratio 4.23, 95% confidence interval 1.48–12.13, P=0.007; effusion: hazard ratio 4.93, 95% confidence interval 1.37–17.69, P=0.015). Combined with the International Prognostic Index score and the presence of pleural or pericardial effusion for the stratification of patients treated with R-CHOP without radiotherapy, patients with lower International Prognostic Index score and the absence of effusion comprised approximately one-half of these patients and could be identified as curable patients (95% overall survival at 4 years). The DA-EPOCH-R regimen might overcome the effect of these adverse prognostic factors. Our simple indicators of International Prognostic Index score and the presence of pleural or pericardial effusion could stratify patients with primary mediastinal large B-cell lymphoma and help guide selection of treatment. 相似文献
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回顾分析2016年9月至2017年8月收治的4例右半结肠合并直肠癌患者的临床资料。4例均符合右半结肠合并直肠重复性癌的诊断标准,其中3例为同时性多原发癌(SCRC),1例为异时性多原发癌(MCRC)。4例患者中,3例SCRC患者均行两个部位的联合根治性手术,在右半结肠根治术中均保留中结肠动脉左支和左结肠动脉;MCRC患者第一次行扩大右半结肠切除术时未保留中结肠动脉左支,第二次行保留左结肠动脉的直肠癌根治术。4例患者术后均未发生吻合口漏等相关并发症,术后随访至今,平均随访时间为8.75±4.57个月,未发生转移或复发。对于右半结肠癌合并直肠癌行右半结肠癌加直肠癌根治性手术时,应保留中结肠动脉的左支及/或左结肠动脉,避免出现剩余结肠发生缺血坏死,出现吻合口漏和狭窄。 相似文献
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Bishoy Abraham MD Juan M. Farina MD Ayman Fath MD Merna Abdou MD Mostafa Elbanna MD Mustafa Suppah MD Mohamed Sleem MD Abdullah Eldaly MD Mohamed Aly MD Michael Megaly MD Pradyumna Agasthi MD Chieh-Ju Chao MD David Fortuin MD Said Alsidawi MD Chadi Ayoub MD Mohamad Alkhouli MD Abdallah El Sabbagh MD David Holmes Jr MD Emmanouil S. Brilakis MD PhD Reza Arsanjani MD 《Catheterization and cardiovascular interventions》2023,102(1):159-165
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Ge Zhang Bo-Wen Chen Xiao-Bo Yang Huai-Yuan Wang Xu Yang Fu-Cun Xie Xiang-Qi Chen Ling-Xiang Yu Jie Shi Yin-Ying Lu Hai-Tao Zhao 《World journal of gastroenterology : WJG》2022,28(41):5968-5981
BACKGROUNDCombined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a form of rare primary liver cancer that combines intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma.AIMTo investigate overall survival (OS) and recurrence-free survival (RFS) after radical resection in patients with cHCC-CCA, and the clinicopathological factors affecting prognosis in two center hospitals of China.METHODSWe reviewed consecutive patients with cHCC-CCA who received radical resection between January 2005 and September 2021 at Peking Union Medical College and the 5th Medical Center of the PLA General Hospital retrospectively. Regular follow-up and clinicopathological characteristics were systematic collected for baseline and prognostic analysis.RESULTSOur study included 95 patients who received radical resection. The majority of these patients were male and 82.7% of these patients were infected with HBV. The mean tumor size was 4.5 cm, and approximately 40% of patients had more than one lesion. The median OS was 26.8 (95%CI: 18.5-43.0) mo, and the median RFS was 7.27 (95%CI: 5.83-10.3) mo. Independent predictors of OS were CA19-9 ≥ 37 U/mL (HR = 8.68, P = 0.002), Child-Pugh score > 5 (HR = 5.52, P = 0.027), tumor number > 1 (HR = 30.85, P = 0.002), tumor size and transarterial chemoembolization (TACE) after surgery (HR = 0.2, P = 0.005).CONCLUSIONThe overall postoperative survival of cHCC-CCA patients is poor, and most patients experience relapse within a short period of time after surgery. Preoperative tumor biomarker (CA19-9, alpha-fetoprotein) levels, tumor size, and Child-Pugh score can significantly affect OS. Adjuvant TACE after surgery prolongs RFS, suggesting that TACE is a possible option for postoperative adjuvant therapy in patients with cHCC-CCA. 相似文献