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BACKGROUND: Macrophages are critical players in regulating innate and adaptive immunity in the tumor microenvironment (TME). The prognostic value of macrophages and their heterogeneous phenotypes in non-small cell lung cancer (NSCLC) is still uncertain. METHODS: Surgically-resected samples of 681 NSCLC cases were stained by multiplex immunofluorescence to examine macrophage phenotypes as well as the expression levels of program death-ligand 1 (PD-L1) on them in both tumor nest and tumor stroma, including pan-macrophage (CD68+), M1 (CD68+CD163−), and M2 macrophages (CD68+CD163+). Various other immune cell markers, including CD4, CD8, CD20, CD38, CD66B, FOXP3, and CD133, were also evaluated. Machine learning algorithm by Random Forest (RF) model was utilized to screen the robust prognostic markers and construct the CD68-based immune-related risk score (IRRS) for predicting disease-free survival (DFS). RESULTS: The expression levels of CD68 were moderately correlated with the levels of PD-L1 (P

Background BRCA1/2 mutation is associated with a high risk of breast cancer, which may preclude breast cancer patients with BRCA1/2 mutation from breast-conserving therapy (BCT) [breast-conserving surgery (BCS), followed by radiotherapy, BCT]. It is debatable whether BCT could be a rational choice for Chinese breast cancer patients with a BRCA1/2 mutation. Methods The study comprised a cohort of women with invasive breast cancer either receiving BCT or mastectomy following the criteria for the germline BRCA1/2 mutation test. Germline DNA for BRCA1/2 testing was derived from blood samples. Survival analyses were performed. The correlations were analyzed between survival and distinct types of surgery. To compare the survival between different surgical management, Kaplan-Meier univariate analysis and multivariate Cox regression was used. Results In BRCA1/2 mutation carriers (N=176) and noncarriers (N=293), 25% and 27.3% of the patients received BCT, respectively (P=0.675). Patients receiving mastectomy (without radiotherapy or followed by radiotherapy) have larger tumor size (P

Purpose We aim to examine nasopharyngeal carcinoma (NPC) characteristics and survival outcomes in patients aged 70 years and older in the intensity-modulated radiotherapy (IMRT) era. Materials and Methods From 2006 to 2013, 126 non-metastatic NPC patients aged ≥ 70 years who were treated with IMRT +/‒ chemotherapy were included. Adult Comorbidity Evaluation 27 (ACE-27) was used to measure patient comorbidities. The overall survival (OS) and cancer-specific survival (CSS)were calculatedwith the Kaplan-Meier method, and differenceswere compared using the log-rank test. The Cox proportional hazards model was used to carry out multivariate analyses. Results For the entire group, only two patients (1.6%) presented stage I disease, and up to 84.1% patients had stage III-IVB disease. All patients had a comorbidity score of 0 in 24 (19.0%), 1 in 45 (35.7%), 2 in 42 (33.3%), and 3 in 15 (11.9%) patients. The main acute grade during radiotherapy was 3-4 adverse events consisting of mucositis (25.4%), bone marrow suppression (16.7%), and dermatitis (8.7%). After treatment, four patients (3.2%) developed temporal lobe injury. Five-year CSS and OS rates were 67.3% (95% confidence interval [CI], 58.6% to 77.4%) and 54.0% (95% CI, 45.6% to 63.9%), respectively. Five-year OS was significantly higher for ACE-27 score 0-1 than ACE-27 score 2-3 (72.9% and 39.9%, respectively; p < 0.001). Multivariate analyses showed ACE-27 score 0-1 was significantly associated with superior OS (hazard ratio [HR], 3.02; 95% CI, 1.64 to 5.55; p < 0.001). In addition, the rate of OS was higher for stage I-III than that of stage IV, with borderline significance (HR, 1.67; 95% CI, 0.99 to 2.82; p=0.053). But no significant advantage was observed in OS when chemotherapy was used (p > 0.05). Conclusion Our findings suggest IMRT +/– chemotherapy has a manageable toxicity and provides an acceptable survival in patients aged ≥ 70 years with NPC. ACE-27 score was significantly associated with survival outcomes in this group population.

To investigate the analgesic effect and safety of Dexmedetomidine compounded with propofol in laparoscopic cholecystectomy patients. 136 patients who underwent elective laparoscopic cholecystectomy from June 2018 to June 2020 in our hospital were selected, and all patients were classified into Class I~II according to the American Society of Anesthesiologists classification, and were divided into control group and observation group according to the random number table method, with 68 patients in each group. The patients in the observation group were first injected with Dexmedetomidine hydrochloride 1 μg/kg intravenously and then propofol 2 mg/kg intravenously for about 10 min. the patients in the control group were treated with placebo, i.e. 5 ml of 0.9 % saline intravenously followed by propofol 2 mg/kg intravenously. The postoperative recovery of the 2 groups was compared; a simple mental status scale score to evaluate the postoperative cognitive function changes; S100 calcium-binding protein B and oxidative stress indexes were measured in patients before and after surgery. The differences in heart rate, mean arterial pressure and blood oxygen saturation between the two groups at T0 were not statistically significant (p>0.05); at T1, heart rate and mean arterial pressure of the two groups were significantly lower than those at T0 (p 0.05). After the administration of blood oxygen saturation, the mean onset of effect time, time of awakening and the dosage of propofol in the observation group were significantly less than that in the control group (p

BACKGROUND: BRCA1/2 mutation is associated with a high risk of breast cancer, which may preclude breast cancer patients with BRCA1/2 mutation from breast-conserving therapy (BCT) [breast-conserving surgery (BCS), followed by radiotherapy, BCT]. It is debatable whether BCT could be a rational choice for Chinese breast cancer patients with a BRCA1/2 mutation. METHODS: The study comprised a cohort of women with invasive breast cancer either receiving BCT or mastectomy following the criteria for the germline BRCA1/2 mutation test. Germline DNA for BRCA1/2 testing was derived from blood samples. Survival analyses were performed. The correlations were analyzed between survival and distinct types of surgery. To compare the survival between different surgical management, Kaplan-Meier univariate analysis and multivariate Cox regression was used. RESULTS: In BRCA1/2 mutation carriers (N=176) and noncarriers (N=293), 25% and 27.3% of the patients received BCT, respectively (P=0.675). Patients receiving mastectomy (without radiotherapy or followed by radiotherapy) have larger tumor size (P

The Central Molecular Zone (CMZ) is a ring-like structure sitting at the center of the Milky Way. Using the 870 $\mu$m continuum map from the APEX Telescope Large Area Survey of the Galaxy (ATLASGAL), we study the anisotropy of the density structure of the gas in the Central Molecular Zone (CMZ) using the 2D correlation function. To quantify the spatial anisotropy, we define the critical angle $\theta_{\rm half}$, as well as the anisotropy parameter $A\equiv \frac{\pi}{4\theta_{\rm half}}-1$. We find that the density structure is strongly anisotropic at the large scale (~ 100 pc), and the degree of spatial anisotropy decreases with the decreasing scale. At the scale of ~ 10 pc, the structure is still mildly anisotropic. In our analyses, we provide a quantitative description of the anisotropic density structure of gas in the CMZ, and the formalism can be applied to different regions to study their differences., Comment: 8 pages,12 figures, accepted by RAA

Background: This study was designed to investigate the prognostic role of the MMP-7-181 A/G gene polymorphism in patients with gastric cancer and to correlate the genotype with clinicopathological features. Methods: The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect the MMP-7-181 A/G gene polymorphism, and prognostic analyses were performed to elucidate the prognostic role of the gene polymorphism. Results: The MMP-7-181 A/A genotype was detected in 83.8% (176/210) of cases, A/G genotype in 16.2% (34/210) of cases and G/G genotype in 0% (0/210) of cases. The MMP-7-181 A/G polymorphism was closely correlated with lymph node metastasis (P=0.037). A/G genotype carriers exhibit lymph node metastasis more frequently than A/A genotype carriers. The MMP-7-181 A/G polymorphism was also strongly correlated with vascular invasion (P=0.003), and A/G genotype carriers show an increase in vascular invasion over A/A genotype carriers. The 5-year overall survival rates of A/A genotype carriers and A/G genotype carriers were 59.56% and 33.33%, respectively. The discrepancy was significant (P=0.0164). The prognosis of A/G genotype carriers was significantly worse than that of A/A genotype carriers. Multivariate survival analysis by Cox regression model confirmed that the MMP-7-181 A/G genotype was an independent prognostic factor of gastric cancer (HR =2.10; 95% CI: 1.09–4.05; P=0.027). Conclusions: The MMP-7-181 A/G genotype was closely correlated with malignant biological behaviors and prognosis of gastric cancer. The MMP-7-181 A/G genotype may serve as valuable prognostic indicator of gastric cancer.

Background Promising efficacy and manageable toxicity of docetaxel-based concurrent chemoradiotherapy (CCRT) were reported in head and neck cancer. In addition, the effect of CCRT in combination with cisplatin and/or 5-fluorouracil on both locoregionally advanced and metastatic/recurrent nasopharyngeal carcinoma (NPC) was verified. However, CCRT with docetaxel for locoregionally advanced NPC are not well studied. This study aimed to compare effectiveness and toxicities of CCRT with weekly docetaxel versus tri-weekly cisplatin for locoregionally advanced NPC. Methods Clinical data of patients with locoregionally advanced NPC newly diagnosed between January 2010 and December 2014 receiving CCRT with either weekly docetaxel (15 mg/m2) or tri-weekly cisplatin (80–100 mg/m2) were reviewed. Propensity score matching at a 1:1 ratio was performed to balance baseline characteristics. Adverse events and survival were compared between the two groups. Results A total of 962 patients were included as the whole cohort, and 448 patients were matched and were regarded as the matched cohort. The median follow-up duration was 48 months for the whole cohort. The 3-year nodal recurrence-free survival rate was significantly increased for patients treated with docetaxel in both the whole (hazard ratio [HR] = 0.37, 95% confidence interval [CI] 0.19–0.72, P = 0.030) and matched cohorts (HR = 0.33, 95% CI 0.14–0.79, P = 0.023). However, no significant differences were observed in overall survival, local recurrence-free survival, and distant metastasis-free survival between the two groups in both cohorts. Significantly higher rates of grade 3 radiodermatitis (6.7% vs. 1.8%, P = 0.001), mucositis (74.5% vs. 37.9%, P

To date the management of glioma remains a great challenge in cancer therapy worldwide. The identification of novel diagnostic and therapeutic methods is required. Although there is data indicating that matrix metalloproteinase (MMP)-26 serves an important role in many human cancer types, its clinical significance in glioma remains uncertain. The present study aimed to evaluate MMP-26 expression in human astrocytic glioma specimens, and investigate its role and significance in the progression of astrocytic glioma. Immunohistochemistry was performed to assess MMP-26 expression in astrocytic glioma tissues. The levels of MMP-26 expression and its relevance to the clinicopathological features and prognostic factors in patients with astrocytic glioma patients were then investigated. The results demonstrated that MMP-26 expression was significantly assocaited with the World Health Organization grade (P

Background: Pathological pain conditions can be triggered after peripheral nerve injury and/or inflammation. It is a major clinical problem that is poorly treated with available therapeutics. Curcumin is a phenolic compound derived from Curcuma longa, being widely used for its antioxidant, anti-inflammatory and immunomodulatory effects. Purpose: This review systematically summarized updated information on the traditional uses of curcumin in order to explore antinociceptive effects in pathological pain and evaluate future therapeutic opportunities clinically. Moreover, some structure–activity relationships would greatly enrich the opportunity of finding new and promising lead compounds and promote the reasonable development of curcumin. Methods: PubMed were searched and the literature from the year 1976 to January 2018 was retrieved using keywords pain and curcumin. Results: This review systematically summarized updated information on the traditional uses, chemical constituents and bioactivities of curcumin, and highlights the recent development of the mechanisms of curcumin in the pathological pain by sciatic nerve injury, spinal cord injury, diabetic neuropathy, alcoholic neuropathy, chemotherapy induced peripheral neuroinflammtion, complete Freund's adjuvant (CFA) injection or carrageenan injection. Importantly, the clinical studies provide a compelling justification for its use as a dietary adjunct for pain relief. And we also present multiple approaches to improve bioavailability of curcumin for the treatment of pathological pain. Conclusion: This review focuses on pre-clinical and clinical studies in the treatment of pathological pain. Although the mechanisms of pain mitigating effects are not very clear, there is compelling evidence proved that curcumin plays an essential role. However, further high-quality clinical studies should be undertaken to establish the clinical effectiveness of curcumin in patients suffering from pathological pain. Potential methods of increase the water solubility and bioavailability of curcumin still need to be studied. These approaches will help in establishing it as remedy for pathological pain.

To derive a suitable method for grading masticator space invasion in nasopharyngeal carcinoma on the basis of magnetic resonance (MR) images and to determine its prognostic value in patients undergoing intensity-modulated radiation therapy.After institutional review board approval and informed consent were acquired, 808 patients with nasopharyngeal carcinoma who were treated with definitive intensity-modulated radiation therapy were analyzed retrospectively. The anatomic sites of masticator space involvement were identified with MR imaging. Overall survival, local relapse-free survival, and distant metastasis-free survival were calculated by using the Kaplan-Meier method and were compared by using the log-rank test. Potential prognostic factors were identified by means of multivariate analysis.Masticator space involvement was diagnosed in 163 of 808 patients (20.2%). Patients with lateral invasion (involvement of the lateral pterygoid muscle of the masticator space and beyond) had significantly poorer overall survival and distant metastasis-free survival than those with medial invasion (involvement of the medial pterygoid muscle of the masticator space) (P = .035 and P = .026, respectively). Furthermore, their overall survival, local relapse-free survival, and distant metastasis-free survival were significantly poorer compared with patients with stage T2 or T3 disease (all P ≤ .023) but similar to patients with stage T4 disease. The grade of masticator space involvement was an independent prognostic factor for overall survival, local relapse-free survival, and distant metastasis-free survival (all P ≤ .023).Masticator space involvement in nasopharyngeal carcinoma should be graded as medial (stage T2 disease) or lateral (stage T4 disease). This can facilitate staging of nasopharyngeal carcinoma and may be a suitable prognostic indicator of survival.

Background: Recently, kinase domain duplications (KDD) in BRAF, EGFR, MET and FGFR1 were reported, along with responses to tyrosine kinase inhibitors (TKI). However, its frequency and clinical outcomes in advanced cancer patients are larglely uncertain. We assessed the frequency of KDD across 14, 491 advanced cancers to reveal the landscape in a wide variety of subtypes. Methods: A multicenter study in China was initiated from July 2013, and advanced cancer patients have been enrolled as of September 2018. We analyzed data from 14, 491 clinical advanced cancer cases, each of which had results from next-generation sequencing (NGS)-based 381 genes panel assay, analogous to the index patient. Results: Of this entire cohort [6837 lung cancer (47.18%), 1894 breast cancer (13.07%), 1325 colorectal cancer (9.14%), 710 urinary system tumor (4.90%), 536 gynecological tumor (3.70%), 592 hepatobiliary cancer (4.09%), 221 gastric cancer (1.53%), 312 soft tissue sarcoma (2.15%), 260 head and neck cancer (1.79%) and 1804 others (12.45%)], 71 patients were identified with KDD, including EGFR (16), BRAF (12), MET (11), FGFR3 (8), RET (3), PDGFRA (3), ROS1 (3), FGFR1 (2), ERBB2 (2), SOX17 (2), ALK (2), KIT (1), NTRK1 (1), BAP1 (1), TMPRSS2 (1), ERBB4 (1), VHL (1), NTRK3 (1). KDD were seen in 0.39% (27/6837) of lung cancer [EGFR(9), BRAF (2), MET (6), FGFR3 (2), RET (1), PDGFRA (1), ROS1 (2), ERBB2 (1), ALK (1), NTRK1 (1), and ERBB4 (1)]; 0.21%(4/1894) of breast cancer [BRAF (1), FGFR3 (2), FGFR1 (1)]; 0.60%(8/1325) of colorectal cancer [EGFR (1), BRAF (3), FGFR3 (2), RET (1), ROS1 (1)]; 0.28%(2/710) of urinary system tumor [TMPRSS2(1), VHL (1)]; 0.19%(1/536) of gynecological tumor [SOX17 (1)]; 0.17%(1/592) of hepatobiliary cancer [EGFR (1)]; 0.45%(1/221) of gastric cancer [ERBB2 (1)]; 0.96%(3/312) of soft tissue sarcoma [EGFR (1), FGFR3 (1), PDGFRA (1)]; 0.77%(2/260) of head and neck cancer [BRAF (2)]; and 1.22%(22/1804) of others [EGFR (4), BRAF (4), MET (5), FGFR3 (1), RET (1), PDGFRA (1), FGFR1 (1), SOX17 (1), ALK (1), KIT (1), BAP1 (1), and NTRK3 (1)]; KDD possibly related to target resistance were seen in ERBB2 amplification gastric cancer and ALK-related NSCLC. Conclusion: Diverse KDD are found across diverse tumor types and may underlie acquired resistance, and can benefit from matched targeted treatment. In addition, for short- or long-term responses to targeted treatment, we can use the NGS assay to explore differential gene alter in the future. Citation Format: Chun-wei Xu, Wen-xian Wang, Xiao-jia Wang, You-cai Zhu, Qu-xia Zhang, Yong Fang, Xiu-yu Cai, Yu Chen, Li Lin, Hong Wang, Mei-yu Fang, Yin-bin Zhang, Shi-jie Lan, Xin Liu, Xing-xiang Pu, Zong-yang Yu, Bing Wan, Jian-ying Li, Xian-bin Liang, Li-ping Wang, Wu Zhuang, Ling Lin, Gang Chen, Tang-feng Lv, Yong Song. Real-world large-scale study kinase domain duplications across diverse tumor types in Chinese populations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1597.

// Rong-Bin Liu 1, 2, 3, * , Jian-Gui Guo 1, 2, 4, 8, * , Tian-Ze Liu 1, 2, * , Cheng-Cheng Guo 1, 2, 5 , Xin-Xiang Fan 6 , Xiao Zhang 1, 2, 3 , Wei-Han Hu 1, 2, 4 and Xiu-Yu Cai 1, 2, 7 1 State Key Laboratory of Oncology in South China, Guangzhou, China 2 Collaborative Innovation Center for Cancer Medicine, Guangzhou, China 3 Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, Guangzhou, China 4 Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China 5 Department of Neurosurgery, Sun Yat-Sen University Cancer Center, Guangzhou, China 6 Department of Urology, Sun Yat-Sen Memorial Hospital, Guangzhou, China 7 Department of VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, China 8 Department of Radiation Oncology, The First People's Hospital of Foshan, Foshan, China * These authors contributed equally to this work Correspondence to: Xiu-Yu Cai, email: caixy@sysucc.org.cn Wei-Han Hu, email: huwh@sysucc.org.cn Keywords: T-ALL, NOTCH1, FBXW7, prognosis, meta-analysis Received: September 20, 2016 Accepted: April 26, 2017 Published: June 19, 2017 ABSTRACT The NOTCH1 signaling pathway is crucial for T-cell development, and NOTCH1 and/or FBXW7 mutations are frequently detected in T-cell acute lymphoblastic leukemia (T-ALL). We performed a systematic review and meta-analysis of 18 randomized controlled trials (RCTs) to assess the prognostic impact of mutations in the NOTCH1 pathway. After retrieving relevant articles from PubMed, EMBASE, and the Cochrane Library, we investigated overall survival (OS) and event-free survival (EFS) with hazard ratios (HRs) using fixed-effects or random-effects models and conducted subgroup analyses based on population and mutation status. NOTCH1/FBXW7 mutations correlated significantly with better prognosis (5-year EFS: HR, 0.57; 95% confidence interval [CI], 0.46 to 0.68; P < 0.001 and 5-year OS: HR, 0.61; 95% CI, 0.51 to 0.74; P < 0.001). The HR for 5-year EFS and OS with NOTCH1 mutations were 0.63 (95% CI, 0.53 to 0.75) and 0.76 (95% CI, 0.60 to 0.95), respectively; with FBXW7 mutations, they were 0.82 (95% CI, 0.60 to 1.11) and 0.79 (95% CI, 0.55 to 1.12), respectively. However, differences between children and adults showed no significance. We conclude that the presence of NOTCH1/FBXW7 mutations is an independent prognostic factor for 5-year EFS and 5-year OS.

In this study, the optical data of tongue color of different syndromes in primary hepatic carcinoma (PHC) were detected by optical spectrum colorimetry, and the chromaticity of tongue color was compared and analyzed. The tongue color characteristics of different syndromes in PHC and the relationship between different syndromes and tongue color were also investigated.Tongue color data from 133 eligible PHC patients were collected by optical spectrum colorimetry and the patients were divided into 4 syndrome groups according to their clinical features. The syndrome groups were liver depression and spleen deficiency (LDSD), accumulation of damp-heat (ADH), deficiency of liver and kidney yin (DLKY), and qi stagnation and blood stasis (QSBS). The variation characteristics of chromaticity coordinates, dominant wavelength, excitation purity and the distribution in the International Commission on Illumination (CIE) LAB uniform color space were measured. At the same time, the differences of overall chromatism, clarity, chroma, saturation and hue were also calculated and analyzed.PHC patients in different syndrome groups exhibited differences in chromaticity coordinates. The dominant wavelength of QSBS was distinctly different from that of the other 3 syndromes. Excitation purity in the syndromes of LDSD, ADH and DLKY showed gradual increases (P0.01). Different syndromes in the CIE LAB color three-dimensional space showed differences in tongue color distribution areas. The CIE hue-angle value of QSBS was negative, and different from that of the other 3 syndromes (P0.01). CIE chroma in the syndromes of LDSD, ADH and DLKY showed gradual increases (P0.01), the same as excitation purity. In the comparison of chromatism, tongue color variations in different syndromes were quantified by human observation.This study shows that tongue color diagnosis according to the syndrome classifications of traditional Chinese medicine can be quantified with optical spectrum colorimetry technology. Different syndromes in PHC exhibit distinct chromatisms of tongue color through the calculation and analysis of chromaticity parameters of CIE, combined with colorimetric system and CIE LAB color space, and these are consistent with the characteristics of clinical tongue color. Applying optical spectrum colorimetry technology to tongue color differentiation has the potential to serve as a reference point in standardizing traditional Chinese medicine syndrome classification in PHC.

Background and Purpose: Cisplatin is the most common chemotherapeutic agent for loco-regionally advanced nasopharyngeal carcinoma (NPC); however, toxicity is a limiting factor for some patients. We retrospectively compared the efficacy and toxicity of weekly docetaxel-based and cisplatin-based concurrent chemoradiotherapy in loco-regionally advanced NPC. Methods and Materials: Eighty-four patients with Stage III and IVA-B NPCs, treated between 2007 and 2008, were retrospectively analyzed. Thirty received weekly docetaxel-based concurrent chemotherapy, and 43 were given weekly cisplatin-based concurrent chemotherapy. Radiotherapy was administered using a conventional technique (seven weeks, 2.0 Gy per fraction, total dose 70-74 Gy) with 6-8 Gy boosts for some patients with locally advanced disease. Results: Median follow-up time was 42.3 months (range, 8.6-50.8 months). There were no significant differences in the 3-year loco-regional failure-free survival (85.6% vs. 92.3%; p=0.264), distant failure-free survival (87.0% vs. 92.5%; p=0.171), progression-free survival (85.7% vs. 88.4%; p=0.411) or overall survival (86.5% vs. 92.5%, p=0.298) of patients treated concurrently with docetaxel or cisplatin. Severe toxicity was not common in either group. Conclusions: Weekly docetaxel-based concurrent chemoradiotherapy is potentially effective and has a tolerable toxicity; however, further investigations are required to determine if docetaxel is superior to cisplatin for advanced stage NPC.

Background Systemic chemotherapy is the major treatment modality for nasopharyngeal carcinoma (NPC) liver metastases. We investigated the effectiveness of radiofrequency ablation (RFA) treatment, which has not been well explored in this disease. Methods One-hundred and thirty-four cases of NPC with liver metastases treated with chemotherapy, chemotherapy with RFA, or RFA alone were retrospectively analyzed. Patient survival was evaluated by the log-rank test. Survival was analyses using the Kaplan–Meier method. Cox multivariate analyses of clinicopathological features and different treatment approaches were conducted. Results Local response rates were 58% in the RFA group, 78% in the chemotherapy group and 93% in the chemotherapy with RFA group (P 1), the dimension of the largest liver metastases (≤3 cm vs. >3 cm), evaluation of treatment (response vs. no response) and disease-free survival (≤12 months vs. >12 months) were independent prognostic factors. Conclusions RFA combined with chemotherapy is a promising treatment for NPC metastatic liver disease with improved local response, PFS, and OS compared to current chemotherapy protocols. J. Surg. Oncol. 2012; 106:322–326. © 2012 Wiley Periodicals, Inc.

We compared the outcomes and rates of survival provided by surgery alone and surgery combined with postoperative radiotherapy for patients with adenoid cystic carcinoma of the palate (ACP), a rare, low-grade malignant tumor arising within the salivary glands. Fifty-eight patients with ACP were included in this retrospective study. ACP at stages T(1), T(2), T(3,) and T(4) was found in 11, 32, 5, and 10 patients, respectively. The patients were treated with surgery alone or underwent surgery combined with postoperative radiotherapy. The 5, 10, and 15year survival rates were 75%, 37.5%, and 25%, respectively, among the 24 patients who underwent surgery alone. These were not significantly different from the rates of 70.6%, 35.3%, and 20.8%, respectively, among the 34 patients who underwent surgery plus postoperative radiotherapy (P=0.21). The 5 and 10year survival rates were significantly greater among patients receiving ⩾60Gy of radiotherapy than those among patients receiving60Gy of radiotherapy (83.3% and 45.8% vs. 40.0% and 10.0%, respectively) (P=0.04). ACP exhibited good long-term survival rates when treated with surgery alone. Addition of postoperative radiotherapy at doses of ⩾60Gy had no effect on survival, but postoperative radiotherapy at doses of60Gy reduced survival. Recurrence within the palate was the main cause of treatment failure.

Postoperative radiotherapy (PRT) is widely advocated for patients with squamous cell carcinomas of the head and neck that are considered to be at high risk of recurrence after surgical resection. The aims of this study were to evaluate the treatment outcomes of PRT for patients with laryngeal carcinoma and to identify the value of several prognostic factors. We reviewed the records of 256 patients treated for laryngeal squamous cell carcinoma between January 1993 and December 2005. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Log-rank test was employed to identify significant prognostic factors for DFS and OS. The Cox proportional hazards model was applied to identify covariates significantly associated with the aforementioned endpoints. Our results showed the 3-, 5-, and 10-year DFS for all patients were 69.9%, 59.5%, and 34.9%, respectively. The 3-, 5-, and 10-year OS rates were 80.8%, 68.6%, and 38.8%, respectively. Significant prognostic factors for both DFS and OS on univariate analysis were grade, primary site, T stage, N stage, overall stage, lymph node metastasis, overall treatment times of radiation, the interval between surgery and radiotherapy, and radiotherapy equipment. Favorable prognostic factors for both DFS and OS on multivariate analysis were lower overall stage, no cervical lymph node metastasis, and using 60Co as radiotherapy equipment. In conclusion, our data suggest that lower overall stage, no cervical lymph node metastasis, and using 60Co as radiotherapy equipment are favorable prognostic factors for DFS and OS and that reducing the overall treatment times of radiation to 6 weeks or less and the interval between surgery and radiotherapy to less than 3 weeks are simple measures to remarkably improve treatment outcome.

Introduction Patients with metastatic nasopharyngeal carcinoma (NPC) have variable survival outcomes. We have previously shown that an elevated peripheral blood lymphocyte-to-monocyte ratio (LMR) is associated with an increased metastatic risk in patients with primary NPC. The present study aimed to investigate the prognostic value of pretreatment LMR in a large cohort of metastatic NPC patients. Methods Clinical data of 672 patients with metastatic NPC diagnosed between January 2003 and December 2009 were analyzed. The peripheral lymphocyte and monocyte counts were retrieved, and LMR was calculated. Receiver operating characteristic (ROC) curve analysis and univariate and multivariate COX proportional hazards analyses were performed to evaluate the association of LMR with overall survival (OS). Results Univariate analysis revealed that an elevated absolute lymphocyte count (≥1.390 × 109/L) and LMR (≥2.475) as well as a decreased monocyte count (

The prognostic value of interim PET or PET/CT performed after 1-4 cycles of chemotherapy has been widely confirmed in Hodgkin lymphoma and diffuse large B-cell lymphoma but remains unknown in T-cell and natural killer (T/NK) cell lymphomas. Therefore, our aim was to investigate the prognostic value of interim and posttherapy PET/CT in T/NK-cell lymphomas.A retrospective analysis was conducted on data from 88 patients with newly diagnosed T/NK-cell lymphoma who underwent interim (after 1-4 cycles of chemotherapy, n = 62) or posttherapy PET/CT (after the completion of first-line therapy, n = 47). Interim and posttherapy PET/CT status (positive vs. negative) was visually interpreted according to criteria of the International Harmonization Project, and PET/CT status was assessed for its ability to predict progression-free survival (PFS) and overall survival (OS).Interim PET/CT results were negative in 17 of 62 (27.4%) cases, and posttherapy PET/CT results were negative in 29 of 47 (61.7%) cases. The 2-y PFS and OS rates were 71.9% and 80.2%, respectively, in patients with negative results at interim PET/CT versus 20.5% and 46.9%, respectively, in patients with positive results (P0.001 and P = 0.022, respectively). The 2-y PFS and OS rates were 57.8% and 78.0%, respectively, in patients with negative results on posttherapy PET/CT versus 0% and 20.4%, respectively, in patients with positive results (P0.001 and P = 0.003, respectively). Bivariate analysis showed that interim PET/CT status and posttherapy PET/CT status remain independent predictors of PFS and OS after controlling for the score on the Prognostic Index for Peripheral T-Cell Lymphoma, Unspecified.Both interim PET/CT status and posttherapy PET/CT status are independent predictors of PFS and OS in T/NK-cell lymphomas.

Background This study was designed to determine the pattern and correlation between expression of the HIF-1α transcriptional targets TGM2 and BNIP3 in laryngeal cancer, and investigate the association of BNIP3 and TGM2 with clinical outcome in laryngeal squamous cell carcinoma (SCC) patients receiving postoperative radiotherapy. Methods Immunostaining with antibodies specific to BNIP3 and TGM2 was performed in formalin-fixed, paraffin-embedded specimens from 148 laryngeal SCC patients. BNIP3 and TGM2 expression was scored as high or low, based on the number of tumor cells stained and the staining intensity. All patients received postoperative radiotherapy. Patient follow up and clinicopathological data were compared using the Chi-squared test, univariate and multivariate analyses, and survival curves were generated using the Kaplan-Meier method and log-rank test. Results The 3, 5 and 10-year overall survival rates (OS) for all patients were 77.7%, 71.6%, 56.4%, respectively. Primary tumor site, T stage, overall stage, lymph-node metastasis, BNIP3 expression and TGM2 expression were significant prognostic factors for OS in univariate analysis. Negative cervical lymph nodes, high BNIP3 expression and low TGM2 expression were independent prognostic factors of improved OS in multivariate analysis. BNIP3 expression correlates with TGM2 expression in laryngeal SCC (P = 0.012). Conclusions This study indicates that lymph-node metastasis, BNIP3 expression and TGM2 expression are independent prognostic factors in laryngeal SCC patients receiving postoperative radiotherapy. Further studies are required to investigate how BNIP3 and/or TGM2 influence the prognosis of laryngeal SCC patients treated with postoperative radiotherapy, and to determine how TGM2 and BNIP3 expression are regulated.

The clinical significance of bilateral breast cancer is unclear and its influence on prognosis is controversial. We compared the characteristics and prognosis of bilateral breast cancer and unilateral breast cancer.Our study included 4,183 patients with breast cancer who were treated at Sun Yat-sen University Cancer Center between January 1, 2000, and December 31, 2007. Bilateral breast cancer was categorized as synchronous (within 3 months) or metachronous (diagnosed after 3 months of first cancer). SPSS was used for data analysis.106 (2.5%) and 31 (0.7%) patients were diagnosed with metachronous and synchronous bilateral cancer. Women with bilateral cancer had more frequent postmenopause, HER-2 negativity, and advanced disease than in patients with unilateral cancer. Young age at diagnosis, invasive lobular carcinoma, ER/PR negativity, HER-2 positivity, radiation, large tumor size (T5 cm), and stage III disease of the first cancer were risk factors for contralateral cancer. The 5-year disease-free survival and overall survival rates were 76 and 83% for unilateral cancer, while 32 and 72% for bilateral cancer (P = 0.000 for both).Bilateral cancer was associated with shorter disease-free survival and overall survival than unilateral cancer. The prognosis of metachronous bilateral cancer, especially those diagnosed within 2 years after the first cancer was significantly worse than synchronous bilateral cancer.

C-reactive protein (CRP) is an acute-phase reactant that is a promising biomarker in patients with cancer of many kinds. The aim of this retrospective study was to evaluate significant changes in CRP levels as a parameter for the response effect and long-term survival of patients with diffuse large B cell lymphoma (DLBCL). Serum CRP data were collected in 94 patients with DLBCL from October 2006 to August 2009 in Cancer Center, Sun Yat-Sen University. Results were correlated with clinical data. The median CRP serum level in patients with DLBCL was 30.91 ± 53.35 in male and 22.39 ± 29.89 mg/L in female. Base line CRP levels were correlated with International Prognostic Index (IPI) scores (p = 0.03). Among the patients with an IPI score of 1–2, base line CRP levels were correlated with long-term survival (p = 0.001). Base line CRP levels were also correlated with OS (p = 0.001) and varied with different clinical stages (p = 0.03). The corresponding CRP levels in the patients with 2 cycles of chemotherapy were correlated with short-term treatment response (p = 0.003) and OS (p = 0.04) or TTP (p = 0.03). CRP serum levels can be used as additional prognostic parameter in patients with diffuse large B cell type lymphoma.

Bone is the most common site of metastases from nasopharyngeal carcinoma (NPC). Zoledronic acid (ZA) used to prevent skeletal-related events (SREs) of bone metastases has shown anti-tumor effects; yet, no report has been found on the survival benefit of ZA in NPC. This study aimed to evaluate whether ZA can bring survival benefits to patients with bone metastases from NPC.A total of 307 patients with of NPC who had bone metastases were analyzed retrospectively. The differences of survival between patients treated with chemotherapy combined with ZA and those with chemotherapy alone were evaluated by the log-rank test. The Cox multivariate analyses of clinical features and different treatment methods of the 307 patients were conducted.The prevalence of SREs in the combined approach group was lower than that with chemotherapy alone (34% vs. 48%, X (2) = 7.003, P = 0.008). The combined approach group had better progression-free survival (PFS) (11.5 vs. 5.5 months, P 0.001) and overall survival (OS) (23.5 vs. 17.5 months, P 0.001) than chemotherapy alone group. Cox multivariate analysis identified the following independent prognostic factors: ZA treatment, bone metastatic sites, baseline serum alkaline phosphatase (ALP) level, SREs and cycles of chemotherapy.ZA treatment combined with chemotherapy could reduce SREs and improve PFS and OS for NPC patients with bone metastases.

Systemic chemotherapy is the major treatment modality for nasopharyngeal carcinoma (NPC) liver metastases. We investigated the effectiveness of radiofrequency ablation (RFA) treatment, which has not been well explored in this disease.One-hundred and thirty-four cases of NPC with liver metastases treated with chemotherapy, chemotherapy with RFA, or RFA alone were retrospectively analyzed. Patient survival was evaluated by the log-rank test. Survival was analyses using the Kaplan-Meier method. Cox multivariate analyses of clinicopathological features and different treatment approaches were conducted.Local response rates were 58% in the RFA group, 78% in the chemotherapy group and 93% in the chemotherapy with RFA group (P 0.001). Increased progression-free survival (PFS) and overall survival (OS) were observed in the chemotherapy with RFA group (P 0.001). Cox multivariate analysis indicated that the number of liver metastases (1 vs.1), the dimension of the largest liver metastases (≤3 cm vs.3 cm), evaluation of treatment (response vs. no response) and disease-free survival (≤12 months vs.12 months) were independent prognostic factors.RFA combined with chemotherapy is a promising treatment for NPC metastatic liver disease with improved local response, PFS, and OS compared to current chemotherapy protocols.