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Background: The aim of this study was to evaluate the survival benefit of radical surgery with additional extensive upper abdominal procedures (EUAS) for the treatment of stage IIIC and IV ovarian cancer with bulky upper abdominal disease (UAD). Methods: An observational study was conducted between 2009 and 2012 involving two different surgical teams. Team A was composed of the "believers" in EUAS and Team B the "non-believers" in EUAS. Patients were divided into a radical surgery group (EUAS group) or a standard surgery group (non-EUAS group) according to whether or not they had received EUAS. All patients underwent primary cytoreductive surgery with the goal of optimal debulking (=1 cm); this was reviewed in the pelvis, middle abdomen, and upper abdomen. The baseline for the two groups was optimal cytoreduction in both the pelvis and middle abdomen. Progression-free survival (PFS) was evaluated. Results: Radical surgery was performed in 70.7% (82/116) and 12.7% (30/237) of the patients by Teams A and B, respectively. The study groups had similar clinicopathologic characteristics. The median PFS and OS were significantly improved in the radical surgery group, compared with standard surgery groups (PFS: 19.5 vs. 13.3 months, HR: 0.61; 95% CI: 0.46-0.80, P < 0.001; OS: not reached vs. 39.3 months, HR: 0.47; 95% CI: 0.30-0.72, P < 0.001). Positive predictors of complete cytoreduction were treatment with neoadjuvant chemotherapy, improved American Society of Anesthesiologists performance status, and the absence of bowel mesenteric carcinomatosis. Conclusions: Radical surgery lengthens the PFS and overall survival times of ovarian cancer patients with bulky UAD. However, a well-designed randomized trial is needed to confirm the present results. [ABSTRACT FROM AUTHOR]

Background: Electroacupuncture (EA) is reported to be an effective treatment for obesity, but its mechanism is unclear. This study aimed to investigate the relationship between hypothalamic LKB1-AMPK-ACC signaling and EA. Methods: Fifty male Sprague-Dawley rats were divided into two groups fed either chow (chow-fed group) or high-fat diet (HF group). After 4 weeks of feeding, obese rats in the HF group (defined as weighing 20 % or more than rats in the chow-fed group) were randomly allocated into an EA or Diet-induced obesity (DIO) group. The EA group was given EA on bilateral ST25-ST36 for 4 weeks, while the DIO group received no further intervention. Body weight of the chow-fed, DIO, and EA groups were measured weekly. mRNA and protein levels of the hypothalamic LKB1-AMPK-ACC signaling pathway were detected using real-time (RT)-PCR and western blot, respectively. Results: After 4 weeks of EA treatment, the weight growth trend of rats in the EA group was inhibited compared with those in the DIO group. RT-PCR and western blotting showed that EA upregulated the transcription of Adenosine 5'-monophosphate -activated protein kinase α2 (AMPKα2), promoted protein expression of Liver kinase B1 (LKB1) and AMPKα1, and inhibited acetyl-CoA carboxylase (ACC) protein expression in the hypothalamus. Conclusions: This study suggests that hypothalamic LKB1-AMPK-ACC signaling plays an important role in EA treatment for obesity. [ABSTRACT FROM AUTHOR]

Background Salvage cytoreductive surgery (SCR) has been shown to improve the survival of cancer patients. This study aimed to determine the survival benefits of SCR for recurrent endometrial cancer in Chinese population. Methods Between January 1995 and May 2012, 75 Chinese patients with recurrent endometrial cancer undergoing SCR were retrospectively analyzed. Results 43 patients (57.3%) had R0 (no visible disease), 15 patients (20.0%) had R1 (residual disease ≤1 cm), and 17 (22.7%) had R2 (residual disease >1 cm) Resection. 35 patients (46.7%) had single, and 40 (53.3%) had multiple sites of recurrence. The median survival time was 18 months, and 5-year overall survival (OS) rate were 42.0%. Multivariate analysis showed that residual disease ≤1 cm and high histology grade were significantly associated with a better OS. The size of the largest recurrent tumors (≤6 cm), solitary recurrent tumor, and age at recurrence (≤56 years old) were associated with optimal SCR. Conclusion Optimal SCR and high histology grade are associated with prolonged overall survival for patients with recurrent endometrial cancer. Patients with young age, tumor size < 6 cm, and solitary recurrent tumor are more likely to benefit from optimal cytoreductive surgery. [ABSTRACT FROM AUTHOR]