ObjectiveTo investigate the relationship between topical reactive lymphoid hyperplasia and postoperative recurrence and survival of gastric cancer patients. MethodsThe clinical and pathological data of gastric cancer patients who underwent D2 radical gastrectomy from January 2007 to July 2009 were retrospectively analyzed. Based on the number of reactive lymph nodes, cases were divided in to topical reactive lymphoid hyperplasia group (RLH, n=18) and non-RLH group (n=43) by using a median method. The postoperative disease-free survival (DFS) and overall survival (OS) rates of patients in different groups were compared using Kaplan-Meier method and log-rank test, respectively. ResultsThere were no significant difference between the two groups in age, gender, pathological stage, surgical approach, extent of surgery or methods of postoperative chemotherapy (P > 0.05). The median disease-free survival time was 50 months in RLH group, and the median disease-free survival time was 39 months in non-RLH group. DFS of patients in RLH group was significant higher than non-RLH group (66.7% vs. 34.9%, P=0.048). The median survival time was 53.6 months and 52.3 months, respectively, in RLH group and non-RLH group. No difference was found in OS between the two groups (72.2% vs. 60.5%, P=0.338). ConclusionTopical reactive lymphoid hyperplasia reactive the immunity of gastric cancer patients and contact postoperative DFS rate.
Objective To discuss influence of spinal surgery on quality of life (QOL) of patients with late-period spinal metastatic tumor and to explore if spinal surgery could influence on survival time of patients or not. Methods From July 2007 to March 2009, we identified patients who were eligible for the observational study hospitalized in Changzheng Hospital, the Second Military Medical University in Shanghai, China. All eligible patients were divided into two groups depending on whether they would receive spinal surgery or not. Then, all eligible patients completed five QOL assessments using the Functional Assessment of Cancer Therapy-General (FACT-G) Questionnaire when they were diagnosed as late-period spinal metastatic tumor, after 1-month treatment, after 3-month treatment, after 6-month treatment, and after 9-month treatment. Survival time of each patient was also recorded. Results We identified 312 patients who were eligible for the study (surgery group, 147 cases; and non-surgery group, 165 cases). There was no significant difference in survival time between the two groups (χ2=3.167, P=0.075). Within 9 months, the surgery group had significantly higher physical well-being scores, emotional well-being scores, functional well-being scores and total QOL scores than the non-surgery group. Conclusion The results of this study suggest that spinal surgery can significantly improve the QOL of patients with late-period spinal metastatic tumor, but cannot prolong the survival time.
Objective To evaluate the long-term efficacy of extended and standard surgery for carcinoma of head of pancreas by using meta-analysis. Methods Related articls （1990-2012） were searched in Pubmed， WOS， Embase， WanFang， SinoMed， and CNKI. Study on quality of these literatures were evaluated by using the Jadad score. The patients with pancreatic head carcinoma underwent extended radical resection and standard radical resection were classified to treatment group and control group， respectively. The mortality， morbidity， and survival rates of 1-， 3-， and 5-year after operation in the two groups were evaluated by using meta-analysis. Results A total of 11 studies fitted the selection crit-eria， including 744 patients. Among them 357 cases were in standard radical resection group and 387 cases in the extended radical resection group. The results of meta-analysis showed that： ①The morbidity after operation did not significantly differed between the extended radical resection group and standard radical resection group （OR=1.360， 95% CI=0.990-1.870， P=0.050）. ②The mortality of the two groups did not significantly differed （OR=0.870， 95% CI=0.430-1.760，P=0.700）. ③There were no significant differences in survival rates of 1-， 3-， and 5-year between the two groups （OR=0.880， 95% CI=0.450-1.720， P=0.710；OR=0.940， 95% CI=0.590-1.480，P=0.710；OR=1.000， 95% CI=0.600-1.67， P=1.000）. Conclusion Compared with standard radical resection， extended radical resection can not improve the survival rates of 1-， 3-， and 5-year after operation， and can’t reduce the mortality and morbidity after operation
Objective To study the effect of various doses of estrogen on tissue injury, blood supply and survival area of skin flap and to investigate its mechanism. Methods Thirty New Zealand white rabbits aged 3-4 months old and weighing 1.5-2.2 kg (male or female) were used. Random pattern skin flap (12 cm × 3 cm in size) taking the central l ine of the rabbit dorsum as axis and with the pedicle attached at the proximal end was prepared, and the flap pedicle division was performed 7 days after operation. The rabbits were divided randomly into three groups (n=10 rabbits per group). At 2, 4, and 6 days after operation, the proximal edge of flap in group A and B received 100 ?g/kg and 50 ?g/kg subcutaneous injection ofestradiol benzoate, respectively, while group C received no further treatment serving as control group. General condition ofthe rabbits was observed after injection, gross observation was performed 3 and 7 days after injection, survival area of the skin flap was measured 7 days after injection, contents of malondialdehyde (MDA) and nitric oxide (NO) were tested 5 days after injection, and the flaps were harvested 4 and 7 days after injection to receive histology and no significant difference was noted between group A and group B (P gt; 0.05). The NEU counts 4 days after injection were (18.20 ±6.24) cells/HP in group A, (21.27 ± 5.34) cells/HP in group B, and (28.78 ± 7.92) cells/HP in group C, and at 7 days after injection, there were (15.16 ± 7.02) cells/HP in group A, (18.12 ± 6.44) cells/HP in group B, and (29.67 ± 9.12) cells/HP in group C. The VEGF score 4 days after injection was (4.02 ± 0.48) points in group A, (4.19 ± 0.66) points in group B and (3.67 ± 0.49) points in group C, and at 7 day after injection, it was (4.96 ± 0.69) points in group A, (5.12 ± 0.77) points in group B, and (3.81 ± 0.54) points in group C. Significant difference was evident between 4 days and 7 days after injection in group A or B in terms of NEU counts and VEGF score (P lt; 0.05), and difference between 4 days and 7 days after injection in group C was not significant (P gt; 0.05), and the differences among 3 groups were significant (P lt; 0.05). Conclusion Estrogen injection can increase VEGF expression and NO content of flap, decrease MDA content and NEU infiltration of flat, and improve survival area of flap.
ObjectiveTo investigate the application status of survival analysis in studies published in Chinese oncology journals, and assess their reporting quality and summarize the existing problems, so as to promote the application of survival analysis and reporting quality. MethodsStudies that used survival analysis were collected from 1 492 studies published in Chinese Journal of Oncology, Chinese Journal of Clinical Oncology, Chinese Journal of Radiation Oncology and Chinese Journal of Cancer Prevention and Treatment in 2013. The application status of survival analysis of included studies was analysed and their reporting quality was evaluated. ResultsA total of 242 survival analysis studies were included. Among them, the utilization rates of Kaplan-Meier method, life table method, log-rank test, Breslow test and Cox proportional hazards model were 91.74%, 3.72%, 78.51%, 0.41% and 46.28%, respectively. 112 studies did multivariate analysis through Cox proportional hazards model. A total of 396 end points and 10 different types of survival time were reported. Overall survival (OS) was reported in 233 studies (92.15%). Survival terms were defined to 158 end points (39.90%) of 103 studies (42.56%). The follow-up rates were mentioned in 155 studies (64.05%), of which 4 studies were under 80% and the lowest was 75.25%, 55 studies were 100%. The main problems of survival analysis studies published in Chinese journals were as follows:None of the studies which used Cox proportional hazards model reported the proportional hazards assumption. None of the studies used the method of parametric survival analysis. 130 studies (53.72%) did not use the method of multiple factor analysis. 139 studies (57.44%) did not define the survival terms. Only 11 of 100 studies which reported loss to follow-up had stated how to treat it in the analysis. None of the studies reported the methods of calculating sample size. None of the studies reported the censoring proportion. ConclusionThe methods of survival analysis are used in a low rate in studies published in Chinese oncology journals, and the overall reporting quality of survival analyses is poor. So the reporting guideline of survival analysis should be developed and the authors should be encouraged to cooperate with professional statisticians, in order to improve the design, analysis and reporting quality of survival analysis studies.
Objective To analyze the influencing factors of short-term curative effect and long-term survival time of patients with tumor-induced malignant central airway obstruction (MCAO) after airway stent implantation. Methods A total of 120 patients with tumor-induced MCAO who underwent airway stent implantation in the hospital from January 2017 to June 2019 were enrolled. According to the cause of stenosis, the patients were divided into two groups: external pressure stenosis group (n=72) and non-external pressure stenosis group (n=48). The general data such as types and staging of tumor, differentiation degree, sites of airway obstruction, obstruction degree and preoperative level of lactate dehydrogenase (LDH). Before and at 7d after stent implantation, partial pressure of oxygen (PaO2), partial pressure of arterial carbon dioxide (PaCO2) and saturation of arterial blood oxygen (SaO2) were detected. Before and at 1 month after stent implantation, diameter at airway obstruction segment, degree of airway obstruction and forced expiratory volume in the first second (FEV1) were detected. Dyspnea index (DI) and scores of Karnofsky performance status (KPS) were evaluated. The survival status at 1 year after surgery was followed up. The survival at 1 year after surgery was analyzed by Kaplan-Meier. The influencing factors of survival after stent implantation were analyzed by COX proportional hazard regression analysis. Results After stent implantation, PaO2, SaO2, diameter at airway obstruction segment, FEV1 and KPS score were significantly increased (P<0.05), while PaCO2, degree of airway obstruction and DI were significantly decreased in external pressure stenosis group and non-external pressure stenosis group (P<0.05). After stent implantation, the KPS score was significantly higher in external pressure stenosis group than that in non-external pressure stenosis group, and the shortness of breath index was significantly lower than that in non-external pressure stenosis group (P<0.05). The survival rate of patients with external pressure stenosis group was 29.17%, and the median survival time was 7.35 months, the survival rate and median survival time in non-external pressure stenosis group was 22.92%, and the median survival time was 6.10 months, and there was no significant difference between the two groups (log-rank χ2=1.542, P=0.214). COX proportional hazard regression analysis showed that tumor staging at stage IV (OR=2.056, P=0.020), preoperative KPS score lower than 50 points (OR=2.002, P=0.027) and no postoperative chemoradiotherapy (OR=4.292, P=0.039) were independent influencing factors of 1-year survival time after stent implantation in MCAO patients. Conclusions The clinical curative effect of airway stent implantation is good on patients with tumor-induced MCAO. Tumor staging at stage IV, preoperative KPS score lower than 50 points and no postoperative chemoradiotherapy are risk factors that affect survival time.
ObjectiveTo evaluate the prognosis value of oncoprotein metadherin (MTDH) in alpha fetoprotein (AFP)negative hepatocellular carcinoma (HCC) patients following curative hepatectomy. MethodsThe expression of MTDH protein in 152 AFP negative HCC patients underwent curative hepatectomy from 2007 to 2010 in this hospital was detected by immunohistochemical stain. Clinicopathologic data for these patients were analyzed. Survival analysis was evaluated with Kaplan-Meier method and log-rank test to compare survival difference. Cox proportional hazard model analysis was used to assess prognostic significance of MTDH in AFP negative HCC patients. ResultsThe rate of MTDH high expression in the AFP negative HCC tissue was 60.53% (92/152). MTDH high expression was associated with tumor diameter (P=0.029), Edmondson grade (P=0.032), microvascular invasion (P=0.024), or tumor recurrence (P=0.014). Univariate and Cox proportional hazard model analysis showed that high expression of MTDH was correlated with the poor survival in AFP negative HCC patients (P=0.002, P=0.017). ConclusionMTDH is an independent predictor for survival in AFP negative HCC patients after curative hepatectomy.
Objective To investigate the prognostic factors related to long-term survival after gastrectomy. Methods A total of 351 patients with gastric cancer who underwent gastrectomy were successfully followed-up in our hospital had been selected from January 2004 to December 2009. The clinicopathological and follow-up data were studied by univariate and multivariate analysis. Results The age, location of tumors, T stage, N stage, TNM stage, and differentiation were related with postoperative survival of patients with gastric cancer by using univariate analysis（P＜0.05）. By using multivariate analysis, location of tumors, T stage, N stage, and chemotherapy were independent prognostic factors（P＜0.05）. Conclusions Location of tumors, depth of tumor invation, lymph node metastasis, and chem-otherapy were independent prognostic factors for gastric cancer patients who underwent gastrectomy. Chemotherapy after surgery could increase the survival rate of gastric cancer patients with lymph node metastasis or in TNM stage Ⅲ.
Markov model is one of the decision analysis models, which is widely used in pharmacoeconomic evaluation studies. In terms of dealing with changes of disease risks during different times, the transition probabilities among different Markov health states becomes hard to calculate. Nevertheless, survival analysis is an available resolution. In this paper, we introduced how to apply survival analysis in calculation of transition probability in time-dependent model based on cumulative probability with a case analysis on advanced gastric cancer Markov model, and provide more information for researchers to build models.
ObjectiveTo investigate the efficacy and safety of using tamoxifen sequential with the third generation aromatase inhibitors versus the third generation aromatase inhibitors or tamoxifen alone for postmenopausal hormone receptor-positive breast cancer patients.MethodsThe Cochrane Library (Issue 10, 2016), PubMed, EMbase, CNKI, and WanFang Data were searched to collect randomized controlled trials on using tamoxifen sequential with the third generation aromatase inhibitors versus the third generation aromatase inhibitors or tamoxifen alone for postmenopausal hormone receptor-positive breast cancer patients from inception to October, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 studies involving 22 005 patients were included. The results of meta-analysis showed that the sequential therapy group was superior to the tamoxifen monotherapy group on overall survival (HR=0.71, 95%CI 0.52 to 0.98, P=0.04) and recurrence-free survival (HR=0.60, 95%CI 0.46 to 0.79, P=0.000 3). However, no significant difference was found in overall survival and disease free survival between the sequential therapy group and the aromatase inhibitors monotherapy group. As to adverse events, compared with the tamoxifen monotherapy group, the sequential therapy group could reduce the incidence of endometrial hyperplasia (OR=0.22, 95%CI 0.11 to 0.45, P<0.000 01), death (OR=0.74, 95%CI 0.66 to 0.84, P<0.000 01) and metastasis (OR=0.79, 95%CI 0.68 to 0.91, P=0.001); however, the incidence of bone fracture was higher in sequential therapy group compared with intamoxifen monotherapy group (OR=1.31, 95%CI 1.13 to 1.51, P=0.000 3).ConclusionThe sequential therapy using tamoxifen and the third generation of aromatase inhibitors is better than tamoxifen monotherapy for postmenopausal hormone receptor-positive breast cancer patients. However, there is no significant difference in survival benefit between the sequential therapy and aromatase inhibitors monotherapy.