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1.
Whitney S. Brandt Wanpu Yan Jian Zhou Kay See Tan Joseph Montecalvo Bernard J. Park Prasad S. Adusumilli James Huang Matthew J. Bott Valerie W. Rusch Daniela Molena William D. Travis Mark G. Kris Jamie E. Chaft David R. Jones 《The Journal of thoracic and cardiovascular surgery》2019,157(2):743-753.e3
Objective
Comparative survival between neoadjuvant chemotherapy and adjuvant chemotherapy for patients with cT2-4N0-1M0 non–small cell lung cancer has not been extensively studied.Methods
Patients with cT2-4N0-1M0 non–small cell lung cancer who received platinum-based chemotherapy were retrospectively identified. Exclusion criteria included stage IV disease, induction radiotherapy, and targeted therapy. The primary end point was disease-free survival. Secondary end points were overall survival, chemotherapy tolerance, and ability of Response Evaluation Criteria In Solid Tumors response to predict survival. Survival was estimated using the Kaplan–Meier method, compared using the log-rank test and Cox proportional hazards models, and stratified using matched pairs after propensity score matching.Results
In total, 330 patients met the inclusion criteria (n = 92/group after propensity-score matching; median follow-up, 42 months). Five-year disease-free survival was 49% (95% confidence interval, 39-61) for neoadjuvant chemotherapy versus 48% (95% confidence interval, 38-61) for adjuvant chemotherapy (P = .70). On multivariable analysis, disease-free survival was not associated with neoadjuvant chemotherapy or adjuvant chemotherapy (hazard ratio, 1.1; 95% confidence interval, 0.64-1.90; P = .737), nor was overall survival (hazard ratio, 1.21; 95% confidence interval, 0.63-2.30; P = .572). The neoadjuvant chemotherapy group was more likely to receive full doses and cycles of chemotherapy (P = .014/0.005) and had fewer grade 3 or greater toxicities (P = .001). Response Evaluation Criteria In Solid Tumors response to neoadjuvant chemotherapy was associated with disease-free survival (P = .035); 15% of patients receiving neoadjuvant chemotherapy (14/92) had a major pathologic response.Conclusions
Timing of chemotherapy, before or after surgery, is not associated with an improvement in overall or disease-free survival among patients with cT2-4N0-1M0 non–small cell lung cancer who undergo complete surgical resection. 相似文献2.
Baccetti B Collodel G Estenoz M Manca D Moretti E Piomboni P 《Human reproduction (Oxford, England)》2005,20(10):2790-2794
BACKGROUND: Asthenozoospermia may sometimes be related to geneticstructural defects of the sperm tail detectable by transmissionelectron microscopy. Dysplasia of the fibrous sheath (DFS) isa genetic sperm defect, characterized by dysplastic developmentof the axonemal and periaxonemal cytoskeleton. We report thecase of an infertile man with normal sperm count and total spermimmotility in which dysplasia of the fibrous sheath, Akap3,Akap4 gene deletions, meiotic segregation of chromosomes 18,X and Y and Y microdeletions were investigated. METHODS: A 32-year-oldman with a 3-year history of primary infertility presented atour Regional Referral Center for Male Infertility. Family medicalhistory, lymphocyte karyotype, PCR analysis, physical examination,hormone assays and semen analysis were performed. RESULTS: Ultrastructuralsperm evaluation showed dysplasia of the fibrous sheath. Immunostainingof AKAP4 protein was negative in sperm tails. PCR analysis revealedintragenic deletions of the Akap3 and Akap4 genes. Fluorescencein situ hybridization on sperm showed a high frequency of XYdisomy. CONCLUSION: In this infertile patient, our results suggesta possible relationship between dysplasia of the fibrous sheath,partial deletions in the Akap3 and Akap4 genes and absence ofAKAP4 protein in the fibrous sheath. These findings, however,were not detected in another four patients with dysplasia ofthe fibrous sheath. Our results require future confirmatorymolecular analyses. 相似文献
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目的:系统评价Ki67表达比例对乳腺癌患者预后的影响,尤其是对无病生存期(DFS)的影响。为临床应用提供循证医学依据。方法:计算机检索PubMed、Embase、Web of Science、Cochrane Library、中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库以及中国生物医学文献数据库(CBM)。应用RevMan 5.3软件对所纳入的数据进行统计学分析。结果:共纳入8篇文献,合计15 643例患者。Meta分析结果显示,纳入文献中的Ki67高比例表达组患者的DFS(HR=1.86,95%CI=1.31~2.65)要低于Ki67低比例表达组,差异有统计学意义。亚组分析中,以种族分亚组的结果与上述类似,差异也有统计学意义;以Ki67表达临界值分亚组,Ki67表达临界值为30%的亚组差异没有统计学意义,表达临界值为其他值的亚组差异有统计学意义。结论:本研究Meta分析显示,Ki67是乳腺癌的一种不良预后因子,Ki67高比例表达的患者有着更低的DFS。 相似文献
4.
【摘要】〓目的〓探讨血清中脂蛋白水平对乳腺癌预后的影响。方法〓回顾分析2003年11月至2008年9月在中山大学孙逸仙纪念医院初诊的244例乳腺癌患者及同期99例健康体者的临床资料。比较两者血清代谢指标的变化,Spearman相关分析总胆固醇、LDL-C与乳腺癌的肿瘤大小的关系,Cox回归模型评估影响无病生存率(DFS)的预后因素。结果〓乳腺癌患者血清总胆固醇(TC)、甘油三酯、低密度脂蛋白(LDL-C)、血糖较正常人高,而高密度脂蛋白(HDL-C)较正常人低;血清总胆固醇、LDL-C水平在ER/PR阳性乳腺癌患者中较Her-2阳性及三阴型乳腺癌低。血清总胆固醇、LDL-C与肿瘤的大小呈正相关。TC≥5.2 mmol/L 组或LDL-C>3.08 mmol/L 组的DFS较TC<5.2 mmol/L 组或LDL-C≤3.08mmol/L 组明显降低(TC 68% vs 77.7%, LDL-C 73.4% vs 86.3%, P<0.05)。结论〓高胆固醇、高LDL-C血症是乳腺癌独立的预后因素。 相似文献
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18FDG-PET following treatment as valid predictor for disease-free survival in Hodgkin''s lymphoma. 总被引:3,自引:1,他引:2
M. de Wit K. H. Bohuslavizki R. Buchert D. Bumann M. Clausen D. K. Hossfeld 《Annals of oncology》2001,12(1):29-37
Purpose:The value of 18FDG-PET to predict the outcomeafter therapy in Hodgkins lymphoma was compared to morphologic stagingand ESR.
Patients and methods:A total of 50 concurrent18FDG-PET and CT studies were performed in 37 patients withHodgkins lymphoma. ESR was evaluated 32 times after treatment wascompleted.
Results:Out of 39 residual masses found by CT 8 relapses couldbe proven. Out of 11 CT exams with CR 3 relapses occurred. CT turned out toshow a sensitivity, specificity, PPV, NPV, and accuracy of 72%,21%, 21%, 73%, and 32%, with respect to predictdisease-free survival (DFS). 18FDG-PET was positive in 22examinations with 10 recurrences in this group. Out of 28 negative18FDG-PET 1 relapse developed 3 years later. 18FDG-PETturned out to show promising sensitivity, specificity, PPV, NPV, and accuracyof 91%, 69%, 46%, 96%, 74%, with respectto predict DFS. ESR was elevated in 12 studies of which 5 relapses could beproven, while out of 20 normal ESR-studies 3 relapses occurred. Thus, ESRturned out to show sensitivity, specificity, PPV, NPV, and accuracy of63%, 71%, 42%, 85%, and 75%, with respectto predict DFS. In summary, only 18FDG-PET was able to predict DFSstatistically significant.
Conclusion:
18FDG-PET can be very useful in patientswith residual masses after treatment. 相似文献
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