Data regarding the role of neoadjuvant chemotherapy(NACT) are not definitive. Several randomized trials and meta-analyses demonstrate that this chemotherapy regimen decreases the morbidity and mortality rates and incr...Data regarding the role of neoadjuvant chemotherapy(NACT) are not definitive. Several randomized trials and meta-analyses demonstrate that this chemotherapy regimen decreases the morbidity and mortality rates and increases complete cytoreduction rates. If combined with hyperthermic intraperitoneal chemotherapy(HIPEC), NACT could potentially further improve upon these already promising results. Moreover the use of NACT could help in evaluating the chemo-sensitivity of the cancer, thus preventing unnecessary HIPEC procedures in chemo-resistant patients. NACT should definitely be considered as a preferred regimen in the management of advanced ovarian cancer, especially in association with cytoreductive surgery + HIPEC procedure in the context of a multidisciplinary team management in an experienced cancer centre.展开更多
目的:探讨血清白蛋白对晚期卵巢癌患者治疗方式选择的评估价值.方法:回顾性分析2012年12月至2018年11月期间在我中心接受手术治疗的ⅢC期~Ⅳ期卵巢癌患者,根据首次治疗前的血清白蛋白水平将患者分为低白蛋白组和正常白蛋白组,并进行预...目的:探讨血清白蛋白对晚期卵巢癌患者治疗方式选择的评估价值.方法:回顾性分析2012年12月至2018年11月期间在我中心接受手术治疗的ⅢC期~Ⅳ期卵巢癌患者,根据首次治疗前的血清白蛋白水平将患者分为低白蛋白组和正常白蛋白组,并进行预后随访.结果:共纳入253例患者,随访截止至2020年5月20日,共完成随访237例,其中低白蛋白组79例,正常白蛋白组158例.相关性分析结果显示,血清白蛋白水平与治疗前血红蛋白水平呈正相关(r=0.141,P=0.03),与总体生存时间(overall survival,OS)呈正相关(r=0.166,P=0.011).低白蛋白组的中位OS为32.33个月,低于正常白蛋白组的38.48个月,但差异无统计学意义(P=0.427).将低白蛋白组中接受初始肿瘤细胞减灭术(primary debulking surgery,PDS)的患者与接受新辅助化疗联合间歇性肿瘤细胞减灭术(neoadjuvant chemotherapy followed by interval debulking surgery,NACT-IDS)的患者进行比较,在腹水、住院时间、肿瘤细胞减灭术效果达R0占比及术后并发症等方面,差异有统计学意义(P<0.05).将正常白蛋白组中接受PDS的患者与接受NACT-IDS的患者进行比较,在腹水、术中输血量、术中出血量、住院时间、肿瘤细胞减灭术效果达R0占比等方面,差异有统计学意义(P<0.05).结论:在血清白蛋白正常的卵巢癌患者中,接受NACT-IDS者与接受PDS者的术后并发症发生率相似;但在低白蛋白血症卵巢癌患者中,接受PDS者术后并发症发生率显著高于接受NACT-IDS者.治疗前低白蛋白血症可作为晚期卵巢癌患者选择NACT-IDS的评估标准之一,有助于降低术后并发症的发生率,同时提高肿瘤切净率.展开更多
Background and objective:The benefit from adjuvant chemotherapy for patients treated with neoadjuvant chemoradiotherapy(NCRT)and curative surgery remains controversial,particularly among those responding well to NCRT....Background and objective:The benefit from adjuvant chemotherapy for patients treated with neoadjuvant chemoradiotherapy(NCRT)and curative surgery remains controversial,particularly among those responding well to NCRT.This retrospective study aimed to clarify the benefits of adjuvant chemotherapy in terms of the oncological outcomes of patients with ypT0–2N0 rectal cancer after NCRT and curative surgery.Methods:All patients with ypT0–2N0 rectal cancer after NCRT and curative resection between 2005 and 2014 were examined.The oncological outcomes between patients treated with adjuvant chemotherapy and those without any chemotherapy were compared.Results:The clinicopathological characteristics of 110 patients were reviewed in this study;one patient was excluded due to lack of follow-up.Of the 109 patients included,58(53.2%)underwent adjuvant chemotherapy(chemo group),whereas the remaining 51(46.8%)did not receive any chemotherapy(non-chemo group).After a median follow-up of 50 months,there were no significant differences in the 5-year overall survival(OS)or recurrence-free survival(RFS)rates between the groups(OS:92.1 vs 86.3%,P=0.375;RFS:80.9 vs 74.7%,P=0.534).Subgroup analysis also demonstrated no significant differences in 5-year OS and RFS rates between patients with ypT0N0 rectal cancer(P=0.712 and P=0.599,respectively)and those with ypT1–2N0 disease(P=0.255 and P=0.278,respectively).Conclusions:These results indicate that patients with ypT0–2N0 rectal cancer after NCRT followed by curative surgery may not derive significant benefit from adjuvant chemotherapy.However,further prospective randomized trials,with larger sample sizes,are warranted to confirm this conclusion.展开更多
文摘Data regarding the role of neoadjuvant chemotherapy(NACT) are not definitive. Several randomized trials and meta-analyses demonstrate that this chemotherapy regimen decreases the morbidity and mortality rates and increases complete cytoreduction rates. If combined with hyperthermic intraperitoneal chemotherapy(HIPEC), NACT could potentially further improve upon these already promising results. Moreover the use of NACT could help in evaluating the chemo-sensitivity of the cancer, thus preventing unnecessary HIPEC procedures in chemo-resistant patients. NACT should definitely be considered as a preferred regimen in the management of advanced ovarian cancer, especially in association with cytoreductive surgery + HIPEC procedure in the context of a multidisciplinary team management in an experienced cancer centre.
文摘目的:探讨血清白蛋白对晚期卵巢癌患者治疗方式选择的评估价值.方法:回顾性分析2012年12月至2018年11月期间在我中心接受手术治疗的ⅢC期~Ⅳ期卵巢癌患者,根据首次治疗前的血清白蛋白水平将患者分为低白蛋白组和正常白蛋白组,并进行预后随访.结果:共纳入253例患者,随访截止至2020年5月20日,共完成随访237例,其中低白蛋白组79例,正常白蛋白组158例.相关性分析结果显示,血清白蛋白水平与治疗前血红蛋白水平呈正相关(r=0.141,P=0.03),与总体生存时间(overall survival,OS)呈正相关(r=0.166,P=0.011).低白蛋白组的中位OS为32.33个月,低于正常白蛋白组的38.48个月,但差异无统计学意义(P=0.427).将低白蛋白组中接受初始肿瘤细胞减灭术(primary debulking surgery,PDS)的患者与接受新辅助化疗联合间歇性肿瘤细胞减灭术(neoadjuvant chemotherapy followed by interval debulking surgery,NACT-IDS)的患者进行比较,在腹水、住院时间、肿瘤细胞减灭术效果达R0占比及术后并发症等方面,差异有统计学意义(P<0.05).将正常白蛋白组中接受PDS的患者与接受NACT-IDS的患者进行比较,在腹水、术中输血量、术中出血量、住院时间、肿瘤细胞减灭术效果达R0占比等方面,差异有统计学意义(P<0.05).结论:在血清白蛋白正常的卵巢癌患者中,接受NACT-IDS者与接受PDS者的术后并发症发生率相似;但在低白蛋白血症卵巢癌患者中,接受PDS者术后并发症发生率显著高于接受NACT-IDS者.治疗前低白蛋白血症可作为晚期卵巢癌患者选择NACT-IDS的评估标准之一,有助于降低术后并发症的发生率,同时提高肿瘤切净率.
基金supported by National Key R&D Program of China(No.2017YFC0908203)and CAMS Initiative for Innovative Medicine(No.CAMS-I2M-003).
文摘Background and objective:The benefit from adjuvant chemotherapy for patients treated with neoadjuvant chemoradiotherapy(NCRT)and curative surgery remains controversial,particularly among those responding well to NCRT.This retrospective study aimed to clarify the benefits of adjuvant chemotherapy in terms of the oncological outcomes of patients with ypT0–2N0 rectal cancer after NCRT and curative surgery.Methods:All patients with ypT0–2N0 rectal cancer after NCRT and curative resection between 2005 and 2014 were examined.The oncological outcomes between patients treated with adjuvant chemotherapy and those without any chemotherapy were compared.Results:The clinicopathological characteristics of 110 patients were reviewed in this study;one patient was excluded due to lack of follow-up.Of the 109 patients included,58(53.2%)underwent adjuvant chemotherapy(chemo group),whereas the remaining 51(46.8%)did not receive any chemotherapy(non-chemo group).After a median follow-up of 50 months,there were no significant differences in the 5-year overall survival(OS)or recurrence-free survival(RFS)rates between the groups(OS:92.1 vs 86.3%,P=0.375;RFS:80.9 vs 74.7%,P=0.534).Subgroup analysis also demonstrated no significant differences in 5-year OS and RFS rates between patients with ypT0N0 rectal cancer(P=0.712 and P=0.599,respectively)and those with ypT1–2N0 disease(P=0.255 and P=0.278,respectively).Conclusions:These results indicate that patients with ypT0–2N0 rectal cancer after NCRT followed by curative surgery may not derive significant benefit from adjuvant chemotherapy.However,further prospective randomized trials,with larger sample sizes,are warranted to confirm this conclusion.
