Molecular and clinical oncology最新文献

To evaluate the association between serum uric acid (SUA) levels and prognosis in patients with nasopharyngeal carcinoma (NPC) treated with a comprehensive regimen of induction chemotherapy, intensity-modulated radiation therapy (IMRT), and adjuvant chemotherapy. A total of 182 patients with NPC treated at the Second Affiliated Hospital of Nanchang University between 2017 and 2021 were retrospectively analyzed. SUA levels were recorded at four time points: Pre-treatment, post-induction chemotherapy, post-IMRT and post-adjuvant chemotherapy. Based on the median post-adjuvant chemotherapy SUA level (350.48 µmol/l), patients were stratified into high (SUA >350 µmol/l) and low (SUA ≤350 µmol/l) groups. Survival outcomes were compared using Kaplan-Meier analysis and log-rank tests. Cox proportional hazards models were employed to identify independent prognostic factors. Changes in SUA levels over time were assessed using repeated-measures ANOVA. The high SUA group demonstrated improved 3-year overall survival (OS; P=0.037), progression-free survival (PFS; P<0.001), and distant metastasis-free survival (DMFS; P=0.001) compared with the low SUA group. No significant difference in locoregional relapse-free survival (P=0.41) was observed. Post-adjuvant chemotherapy SUA levels were an independent prognostic factor for OS, PFS and DMFS. Repeated-measures ANOVA showed a significant reduction in SUA levels post-IMRT compared with baseline, post-induction chemotherapy, and post-adjuvant chemotherapy (all P<0.001). In conclusion, elevated post-adjuvant chemotherapy SUA levels are associated with improved survival outcomes in patients with advanced-stage NPC. IMRT induces a transient decrease in SUA levels. These findings suggested that SUA levels may serve as a valuable prognostic biomarker for NPC.

Seroma formation is one of the unresolved complications of breast cancer surgery. The use of energy devices (EDs) can improve breast cancer surgery outcomes. Dissection of the pectoralis fascia is an important process in total mastectomy, which involves a wide area of the posterior wall of the mammary glands. The current study investigated whether using EDs for this process could lead to a reduction in seroma formation or potentially reduce other complications. In the present observational study, the use of an ED for pectoralis fascia dissection was compared with conventional electrocautery. The main outcomes were the total amount of drainage (total AD), amount of drainage per day and adverse events (AEs) after propensity score matching (PSM). in addition, a univariate analysis of AE occurrence was performed. Overall, 41 and 117 patients were included in the ED and control groups, respectively. PSM was performed for three covariates: Presence or absence of axillary dissection, preoperative chemotherapy and body mass index >25 kg/m². Compared with those in the control group, the total AD post-PSM in the ED group did not decrease (P=0.1778), whereas the amount of drainage per day was markedly decreased on postoperative day 8 in the ED group. In the univariate analysis, only the use of ED was associated with a reduction in AEs requiring intervention; other factors showed no significant association. The frequency of AEs requiring intervention was significantly lower in the ED group than that in the control group post-PSM (P=0.0372). Notably, seroma accounted for most AEs. The results of the present study suggested that pectoralis fascia dissection using an ED may reduce fluid drainage and the incidence of AEs. This simple modification suggests the possibility of improving surgical techniques and is expected to contribute to favorable surgical outcomes.