Men and women show similar survival outcome in stage IV breast cancer

PurposeTo evaluate the clinicopathological features, patterns of distant metastases, and survival outcome between stage IV male breast cancer (MBC) and female breast cancer (FBC).MethodsPatients diagnosed with stage IV MBC and FBC between 2010 and 2013 were included using the Surveillance, Epidemiology, and End Results program. Univariate and multivariate Cox regression analyses were used to analyze risk factors for overall survival (OS).ResultsA total of 4997 patients were identified, including 60 MBC and 4937 FBC. Compared with FBC, patients with MBC were associated with a significantly higher rate of estrogen receptor-positive, progesterone receptor-positive, unmarried, lung metastases, and a lower frequency of liver metastases. Univariate and multivariate analyses showed no significant difference in OS between MBC and FBC. In the propensity score-matched population, there was also no difference in survival between MBC and FBC. Multivariate analysis of MBC showed that OS was longer for patients aged 50–69 years and with estrogen receptor–positive disease.ConclusionsThere was no significant difference in survival outcome between stage IV MBC and FBC, but significant differences in clinicopathological features and patterns of metastases between the genders.     

Application of adjuvant skin-marker positioning in overweight patients with thoracic and abdominal tumors

Objective To investigate whether adjuvant skin-marker positioning can decrease the set-up errors in overweight patients with thoracic and abdominal tumors. Methods A total of 60 overweight patients with thoracic and abdominal tumors treated with radiotherapy in the First Affiliated of Fujian Medical University between January 2018 and December 2018 were randomly divided into two groups. In group A, conventional skin-marker positioning was adopted. In group B, conventional skin-marker positioning combined with adjuvant skin-marker position was employed. All patients were immobilized with thermoplastic positioning body membrane with head-body plate fixation. The set-up errors in the right-left, head-foot and dorsoventral directions were obtained from cone-beam CT (CBCT) scan system before radiation delivery. The set-up errors were statistically compared between two groups by using t-test. Results In group A, the set-up errors in the right-left, head-foot and dorsoventral directions were (4.47±2.91) mm,(5.43±2.61) mm and (3.87±2.40) mm, significantly higher compared with (2.97±1.68) mm,(3.21±1.62) mm and (2.59±1.57) mm, respectively (all P<0.001). Conclusion Adjuvant skin-marker positioning method can reduce the set-up errors and enhance the positioning repeatability in overweight patients with thoracic and abdominal tumors receiving radiotherapy.     

表皮肿瘤组织超氧化物歧化酶的表达及意义

目的 :探讨铜锌超氧化物歧化酶(CuZnSOD)和锰超氧化物歧化酶 (MnSOD)在表皮肿瘤中的表达及作用。方法 :通过半定量逆转录聚合酶链式反应 (RT PCR)和蛋白免疫印记 (WesternBlot)方法 ,研究了 2 6例基底细胞癌(Basalcellcarcinoma)、2 3例鳞状细胞癌 (Squa mascellcarcinoma)、18例日光性角化 (ActinicKeratosis)以及 8例曝光部正常皮肤、8例非曝光部正常皮肤中CuZnSOD和MnSOD的mRNA和蛋白表达水平。结果 :正常皮肤曝光部和非曝光部 2种SOD的mRNA和蛋白表达无差别 ;表皮肿瘤中CuZnSODmRNA表达与正常皮肤一致 ,MnSODmRNA表达升高 ;表皮肿瘤中 2种SOD蛋白的表达较正常皮肤低。结论 :表皮肿瘤中SOD的mRNA与蛋白表达水平存在差异 ,低蛋白表达可能与表皮肿瘤发生有关。     

血红蛋白浓度对鼻咽癌放射治疗远期疗效的影响

目的 探讨鼻咽癌(NPC)患者的血红蛋白浓度(HBC)对放射治疗远期疗效的影响. 方法 回顾性分析1995年1月1日～1998年12月31日接受根治性放疗的NPC患者1 470例.根据放疗前HBC分为贫血组(男性＜120 g/L,女性＜110 g/L) 和无贫血组(男性≥120 g/L,女性≥110 g/L).根据放疗前后HBC变化情况分为HBC下降组(放疗结束时HBC低于放疗前)和HBC未下降组 (放疗结束时HBC不低于放疗前). 结果 贫血组和无贫血组的生存率差别有统计学意义(P＜0.01),其5年生存率分别为63.35%和53.17%,8年生存率分别为70.36%和61.06%.在贫血组中,HBC下降组的生存率较未下降组低(P＜0.01).Cox回归分析,影响NPC生存率的独立预后因素有放疗前HBC是否低于正常值、T分期、N分期、临床分期、化疗、性别、年龄. 结论 NPC患者放疗前HBC低于正常值是影响长期生存率的独立不良因素之一.     

Is lymph node dissection necessary for staging while undergoing nephrectomy in patients with renal cell carcinoma?

Objective: The essential treatment for patients with renal cell carcinoma is nephrectomy. As no lymph node dissection (LND) could be performed in the majority of these patients, healthy staging could not be carried out. In this study, we investigated the impact of LND during nephrectomy on patient survival. Methods: A total of 181 patients—58 (32%) were female and 123 (68%) were male—were included in the study. Median follow-up period was 48 months. The patients were separated into 4 groups according to their stage during diagnosis; group 1 (T1–3N0M0), group 2 (T1–3NXM0), group 3 (T1–3N1M0), and group 4 (T1–4N0/XM1). The disease-free survival of nonmetastatic patients and the overall survival of all groups were calculated. Results: Mean age was 58.4 ± 12.0 years. Median survival for Group 1 could not be reached. Median survival was 89 months in Group 2, 50 months in Group 3, and 39 months in Group 4 (P <0.001). There was no statistically significant difference between the N1 and M1 groups (P = 0.297). For the NX patient group without LND, median survival was 89 months, which is worse than the N0 group and better than the N1 group (P = 0.002). Conclusions: Our study presumes that the patients without LND are not staged sufficiently, NX patients have worse survival rates when compared with N0 patients, node-positive patients have poor survival rates as do the metastatic patients, and it should be defined as TNM stage4.     

High expression of HOXA5 is associated with poor prognosis in acute myeloid leukemia

Background: HOXA5 is considered as an oncogene in many tumors. This study in- vestigated the HOXA5 expression in Chinese acute myeloid leukemia (AML) patients and evaluated the predictive significance of HOXA5 with a single-center retrospective study. Methods: We investigated the expression pattern and prognostic value of HOXA5 in patients with AML through by using a series of databases and various datasets, including the ONCOMINE, TCGA, and STRING datasets. The bone marrow samples of 53 newly diagnosed AML patients (non-M3 subtype) and 19 benign individuals were collected in our center. HOXA5 mRNA expression levels were detected by real-time qPCR, HOXA5 protein expression levels were detected by Western Blot. Clinical data was obtained from inpatient medical records. Results: Two microarrays in Oncomine showed that the expression level of HOXA5 was significantly upregulated in AML. Our data revealed that AML patients had higher HOXA5 mRNA and protein expression levels than the controls (P < 0.001). The blast percentage in bone marrow of HOXA5 high-expression group was higher that of HOXA5 low-expression group (P < 0.05). Higher expression level of HOXA5 revealed a worse OS in AML (P < 0.05). Conclusion: Our findings suggested that HOXA5 might have the potential ability to act as a diagnostic biomarker and potential therapeutic target for AML.     

肿瘤相关静脉血栓栓塞症的风险评估及预防策略——基于放疗科“无栓病房”的临床实践

［摘要］　肿瘤相关静脉血栓栓塞症（CAT）是指恶性肿瘤合并静脉血栓栓塞症,包括深静脉血栓形成、浅表性血栓静脉炎和肺栓塞,是肿瘤患者常见的并发症和死亡原因。肿瘤疾病存在复杂性,血栓风险和出血风险随肿瘤类型、分期和疾病进展而变化。“无栓病房”是一种全新的医护管理模式,对住院患者采用静脉血栓栓塞症风险评估表进行评分,根据评估结果将患者分为低危和高危患者并进行适当干预,以更好地监测患者的实时栓塞风险,及早预防静脉血栓栓塞症的发生。通过打造“无栓病房”,有效提高医护人员对血栓的诊疗水平,强化患者和家属对血栓的认识。该文基于该院放疗科“无栓病房”的临床实践,对CAT的现状、风险评估以及预防策略进行综述。     

奥沙利铂与5-FU同步放化疗治疗局部晚期胰腺癌

目的回顾性分析奥沙利铂与5-FU同步放化疗治疗局部晚期胰腺癌的治疗结果,探讨局部晚期胰腺癌的治疗策略。方法对局部晚期胰腺癌56例,予以三维适形放疗同步配合5-FU＋奥沙利铂化疗,放疗剂量为56-60 Gy/28-30次/38-50天,5-FU 250 mg/（m2.d-1）持续静脉给药直至放疗结束,奥沙利铂40-50 mg/m^2,第1、8、15、22、29天。用Kaplan-Meier法估算患者的生存率。结果（1）全组患者中位无进展生存时间及总生存时间分别为5.1月及15.2月,无进展生存率（PFS）、总生存率（OS）分别为1年：42.8%、64.3%,2年：14.7%、21.6%。（2）完全缓解（CR）2例（3.6%）,部分缓解（PR）25例（44.6%）,有效率（RR=CR＋PR）为48.2%。（3）总的临床获益率（CBR）为66.1%,其中92.5%（37/40）疼痛减轻,73.2%（41/56）Karnofsky评分提高,14.3%（8/56）体重增加。（4）急性毒副反应主要为1~2级的骨髓抑制、消化道反应和感觉性神经炎,3级毒副反应只见于中性粒细胞下降（5.4%）和恶心呕吐（19.6%）,未发现4级毒副反应。未发现消化道出血、梗阻和放射性肝炎等远期并发症。（5）死亡的首位原因为远处转移,占59.6%（28/47）。结论（1）奥沙利铂与5-FU同步放化疗治疗局部晚期胰腺癌疗效较好,且安全可行,是个很有前途的治疗方案。（2）由于死亡的首位原因为远处转移,放化疗前予以诱导化疗可能会提高局部晚期胰腺癌的生存期。     

Selective Denervation of Pectoralis Major Muscle Improves Cosmetic Outcome and Quality of Life in Retro-Pectoral Implant Based Breast Reconstruction

BackgroundSelective pectoralis major muscle (PMM) denervation has been described in retro-pectoral reconstructions to obtain the advantages of the pre-pectoral approach. Present study compared subjective evaluations between retro-pectoral implant based breast reconstructions (IBBRs) with denervation to traditional techniques without denervation. Methods. In 2020, two 2 groups of patients submitted to retro-pectoral IBBR, minimum 12-month follow-up, were compared through BREAST-Q post-operative questionnaire. Group-1 included direct-to-implant or two2-stage tissue expanderTE cases with selective PMM denervation, while Group-2 similar procedures, in the same time span 2017-2019, without denervation. BREAST-Q was divided into five 5 independent scales and for each scale item responses were summed up and transformed into a score, ranging from 0 to 100, to analyze and compare the results. Results. 50 patients were included both in Group1 and Group-2. Group-1 patients reported significantly higher scores in “satisfaction with the reconstructed breast” scale compared to Group-2, means-medians of 56-58 and 47-50, respectively. A trend in favor of Group-1 was recorded in the scales of “psycho-social well-being”, 64-65 vs. 58-53, and “sexual well-being”, 53-47 vs. 48-47, albeit not significant. Substantial equivalence was found in “satisfaction with the result overall” and “physical well-being”. Conclusion. PMM denervation can improve cosmetic results in retro-pec IBBRs, thus leading to better QoL. Possible pain and physical discomfort weren't caused by denervation with scores similar to non-denervated controls.