ObjectiveTo explore the role of toremifene in postmenopausal operable patients with luminal subtype of breast cancer in China. MethodsA total of 618 eligible patients diagnosed with luminal subtype of breast cancer from January 2000 to December 2009 in the Cancer Center of Sun Yat-sen University were analyzed. One hundred and fifteen patients were treated with toremifene(toremifene group) and 503 patients were treated with tamoxifen(tamoxifen group) as adjuvant endocrine therapy. Survival was compared by Kaplan-Meier with log-rank test in two groups. Cox analysis was used to compare different prognostic factors. ResultsThe general clinical data had no significant differences between the toremifene group and tamoxifen group (P > 0.05). After a median follow-up of 76 months, there was no statistical difference in the 5-year disease free survival rate and 5-year overall survival rate between the toremifene group and the tamoxifen group (5-year disease free survival rate:78.5% versus 85.5%, P=0.083;5-year overall survival rate:86.4% versus 92.0%, P=0.334). Univariated analysis showed that the histological grade, tumor size, lymph node status, TNM stage, HER-2 positive expression were associated with the disease free survival rate and overall survival rate(P < 0.05). Multivariated analysis showed that the tumor size and lymph node status were the independent risk factors of disease free survival rate and overall survival rate for postmenopausal operable patients with luminal subtype of breast cancer(P < 0.05). HER-2 positive expression was the independent risk factor in predicting disease free survival rate for patients with tamoxifen or toremifene. There was no grade 3 or 4 toxicity for all the patients according to CTC AE 4.0 grade. ConclusionsSimilar benefit is found in disease free survival rate and overall survival rate in Chinese postmenopausal patients with operable luminal subtype of breast cancer between patients receiving toremifene and tamoxifen with tolerable adverse effects. HER-2 status is associated with disease free survival rate.
ObjectiveTo evaluate the efficacy and safety of robot-assisted thoracoscopic esophagectomy in the treatment of esophageal carcinoma. MethodsWe retrospectively analyzed the clinical data of 79 patients with robotassisted thoracoscopic esophagectomy in our hospital from August 2010 to June 2015. There were 43 males and 36 females at average age of 62 years. The clinical effect was analyzed. ResultsThe mean operation time was 245 min (range 170 min to 330 min). The mean blood loss was 75 ml (range 20 ml to 310 ml). The mean hospital stay was 10.2 days (range 7 days to 26 days). Two perioperative deaths occurred. A total of 14 (17.7%) patients with complication were reported. Mean lymph node harvest was 20.7 nodes with 10.9 in chest, 9.6 in abdomen. ConclusionRobot-assisted thoracoscopic esophagectomy is technically feasible and safe. It is expected to reduce surgical trauma and reduce the incidence of pulmonary complications.