Objective To use a meta-analysis method to establish quantitatively the association between the HER-2/neu gene amplification/enhanced protein expression status and the 5-year post-operative survival rate or median survival time in women with epithelial ovarian carcinoma. Methods We searched and screened Chinese and English literature published since 1989 to collect all retrospective cohort studies on the prognostic significance of HER-2/neu status in this population. The survival data were analyzed using Ludwig’s centered signed rank and the DerSimonian-Laird method. Results In total, 25 studies involving 3 251 patients were included. HER-2/neu was positive in 27.1% (95%CI 0 to 54.8%) of patients, which was not related to the pathological stage, type or grade of epithelial ovarian carcinoma. In HER-2/neu positive cases, the median survival time was shortened by 0.65 years, and the 5-year survival rate was lowered. The hazard ratio (HR) for mortality was 1.22 (95%C 1.09 to 1.36). By subgroup analysis, HER-2/neu protein expression was found to be most significant in prognostic assessment. Patients with a b positive value of HER-2/neu had an increased HR for the 5-year survival; and platinum-based chemotherapy was demonstrated to be less effective in HER-2/neu positive ovarian carcinoma. Conclusion In gynecological oncology, it is reasonable to measure HER-2/neu as a routine pathological marker to predict a patient’s prognosis and to determine the most appropriate adjuvant chemotherapy regimen.
ObjectiveTo analyze the influence of different surgical methods on survival and relapse-free survival in colorectal liver metastases. MethodsClinical data of 71 cases of colorectal liver metastases who treated in PLA General Hospital from January 2002 to may 2013 were collected retrospectively, to analyzed the effect of different surgical methods on survival and relapse-free survival of this kind of cases. ResultsAll of primary lesions underwent radical resection. And for the liver metastases, 20 cases didn't received any intervention (non-intervention group), 20 cases underwent resection of liver metastases, 20 cases underwent radiofrequency ablation, and 11 cases underwent radiofrequency ablation and resection of liver metastases (all 61 cases who received intervention were classified to intervention group). Results of Cox proportional hazards model showed that, in the condition of controlling other confounding factors, intervention can improve the survival (HR=1.724, P=0.043) and relapse-free survival (HR=0.701, P=0.048) of cases of colorectal liver metastases, cases who received intervention had better survival situation and the relapse-free survival situation. ConclusionFor cases of colorectal liver metastases, in condition of radical operation for colorectal cancer, the intervention for liver metastases can prolong the survival time and relapse-free survival time.
ObjectiveTo explore the possible factors which influence the survival time of elderly patients with esophageal cancer.MethodsWe retrospectively analyzed the data of patients with esophageal cancer treated in the First Hospital of Lanzhou University, Gansu Province Tumor Hospital from January 2012 to October 2016. Kaplan-Meier method was used to estimate and analyze the single factor, survival curve with log-rank test. The Cox regression model was used for multivariate prognostic analysis．ResultsAccording to the inclusion and exclusion criteria, 302 patients were eventually collected, including 231 males and 71 females, with an average age of 66.0±6.0 years. The univariate analysis showed that age, tumor stage, tumor site, Karnosfsky performance satus (KPS) score, and treatment were prognostic factors (P<0.05). Multivariate analysis showed that the patient age and treatment were independent factors for overall survival (OS) and progress-free survival (PFS) (P<0.05). The OS and PFS of the patients with age≤70 years were better than those of the patients more than 70 years. Chemotherapy alone and surgery alone was better for survival situation than radiotherapy alone.ConclusionAge and treatment are independent prognostic factors in survival time of the elderly patients with esophageal cancer.
ObjectiveTo analyze the R0 resection rate and survival time of pancreatic cancer with serum IgG4 elevated, and to discuss whether serum IgG4 can distinguish autoimmune pancreatitis from pancreatic cancer.MethodsThe retrospective cohort study was adopted. The clinical data of 146 patients with pancreatic cancer confirmed by histology in Affiliated Hospital of Qingdao University from January 2016 to December 2019 were analyzed retrospectively. According to the level of serum IgG4, they were divided into normal IgG4 group (<1.35 g/L, n=124) and IgG4 elevated group (≥1.35 g/L, n=22). The tumor R0 resection rate, survival time and whether complicated with AIP of the two groups were compared.ResultsOne hundred and one patients (81.5%) with normal serum IgG4 underwent radical surgery, while only 13 patients (59.1%) with elevated serum IgG4 underwent radical surgery, the difference was significant (P=0.019). The median survival time of patients with normal serum IgG4 was 18.7 months, while patients with elevated serum IgG4 was 8.1 months, there was no significant difference between the two groups (P=0.121). Subgroup analysis showed that the median survival time of patients with pancreatic ductal adenocarcinoma in the normal IgG4 group was 17.5 months, while the IgG4 elevated group was 6.8 months, the difference was significant (P=0.016). Only 1 case of pancreatic cancer with AIP in the 2 groups.ConclusionsSerum IgG4 ≥1.35 g/L indicates low radical resection rate in pancreatic cancer and poor prognosis in pancreatic ductal adenocarcinoma. Serum IgG4 can only be used as an auxiliary index to distinguish pancreatic cancer from autoimmune pancreatitis.
ObjectiveTo explore the related factors of postoperative survival of patient with gastric cancer, so as to provide the corresponding evidence support for the prognosis evaluation.MethodsThe clinicopathologic data of patients with gastric cancer who underwent surgical treatment in the Fourth Affiliated Hospital of Baotou Medical College and the Fourth Hospital of Baotou City from January 2006 to December 2009 were retrospectively collected. The influences of clinicopathologic data (gender, age, tumor size, tumor location, lymph node metastasis, tumor thrombus, tumor differentiation, TNM stage, operation mode, and postoperative chemotherapy) on postoperative survival of patients with gastric cancer were analyzed. Univariate analysis was used to analyze the influencing factors of postoperative survival in the patients with gastric cancer and Cox proportional hazards regression was used to analyze the independent risk factors.ResultsA total of 80 patients with gastric cancer were included in this study. Up to December 31, 2014, the median survival time at 50% cumulative survival rate was 95 months. Univariate analysis showed that the survival of patients with gastric cancer was related to tumor size, lymph node metastasis, tumor differentiation, and TNM stage (P<0.05). Further multivariate analysis showed that later TNM stage was an independent risk factor for affecting postoperative survival of patients with gastric cancer (P<0.05).ConclusionPostoperative survival of patients with gastric cancer is related to tumor size, lymph node metastasis, tumor differentiation, and TNM stage; And later TNM stage is an independent risk factor for affecting survival of patients with gastric cancer.
Objective To investigate and analyze the clinical features of primary pulmonary malignant melanoma. Methods The medical records, imaging examinations, pathological results, treatment and prognosis of four primary pulmonary malignant melanoma (PMML) patients were retrospectively collected. In combination with 96 cases reported in the literature, a total of 100 patients with PMML were analyzed. Results Among the 100 PMML patients, there were 60 males (60.0%) and 40 females (40.0%), with an average age of 56.9±10.3 years. Common clinical symptoms were cough (60.0%), chest tightness or pain (18.0%), hemoptysis (16.0%), and dyspnea (11.0%). Distant metastasis was found in 30 cases (30.0%) at the time of consultation. The clinical stage of the first diagnosis and evaluation of the patients was stage Ⅰ in 7 cases (7.0%), stage Ⅱ in 24 cases (24.0%), stage Ⅲ in 13 cases (13.0%), stage Ⅳ in 39 cases (39.0%), and 17 cases (17.0%) did not mention a clear tumor stage. Thirty patients (30.0%) received comprehensive anti-tumor therapy, 53 patients (53.0%) received surgical resection, and 17 patients among them (17.0%) received postoperative adjuvant comprehensive therapy. The overall median survival time of PMML patients was 8.0 (2.0 - 14.4) months. The median survival time of stage Ⅳ PMML patients was 5.0 (3.1 - 6.9) months, which was significantly lower than 24.0 (6.0 - 32.0) months of stage Ⅱ patients (P<0.05) and 15.0 (0.6 - 29.4) months of stage Ⅲ patients (P<0.05). Further analysis showed that different treatment regimens had no significant effect on the median survival time of patients with stage Ⅳ PMML (P>0.05). Conclusions PMML has a high degree of malignancy and no specific clinical symptoms. It is mainly diagnosed by pathology. Surgical resection, postoperative adjuvant chemoradiotherapy or immunotherapy are the main treatment methods, but its overall prognosis is poor.
Objective To analyze the clinicopathological characteristics of thymoma patients and the influencing factors for prognosis. Methods Thymoma patients who received treatment in Sichuan Cancer Hospital from March 2015 to March 2021 were collected. Clinical data of the patients were analyzed using Kaplan-Meier and Cox regression analyses. Results A total of 177 patients were included. There were 89 males and 88 females aged 17-88 (52.3±13.0) years, including 160 surgical patients and 17 non-surgical patients. There were 160 patients survived, 17 died of thymoma, and 5 had recurrence and metastasis. Overall, the 1-year, 3-year and 5-year progression-free survival rates were 94.4%, 88.7%, 88.1%, respectively; the 1-year, 3-year and 5-year overall survival rates were 94.9%, 91.5%, 91.0%, respectively. The Kaplan-Meier analysis showed that World Health Organization classification, clinical symptoms, Masaoka-Koga staging, treatment methods and surgery were statistically associated with progression-free survival; clinical symptoms, age, treatment methods and surgery were statistically associated with overall survival (P<0.05). Patients with younger age (P=0.018), without clinical symptoms (P=0.039), and with surgical treatment (P=0.004) had higher overall survival rates; those patients undergoing surgery had a higher progression-free survival rate (P=0.002). Conclusion Age, clinical symptoms and surgical treatment are independent factors influencing the prognosis of patients with thymoma.