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ASO Author Reflections: Hepatic Resection as the Primary Treatment Modality for Hepatocellular Carcinoma After Orthotopic Liver Transplantation. ASO 作者反思:将肝切除作为原位肝移植后肝细胞癌的主要治疗方式。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-14 DOI: 10.1245/s10434-024-16237-1
Abraham J Matar, Kailey M Oppat, Frances J Bennett, Emilie A K Warren, Chase J Wehrle, Zhihao Li, Luckshi Rajendran, Zachary P Rokop, Chandrashekhar Kubal, Ben E Biesterveld, David P Foley, Mayumi Maeda, Mindie H Nguyen, Beth Elinoff, Abhinav Humar, Dimitrios Moris, Debra Sudan, John Klein, Juliet Emamaullee, Vatche Agopian, Parsia A Vagefi, Shukri H A Dualeh, Christopher J Sonnenday, Gonzalo Sapisochin, Federico N Aucejo, Shishir K Maithel
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引用次数: 0
Adult Prostate Sarcoma: Demographics, Treatment Patterns, and Survival. 成人前列腺肉瘤:人口统计学、治疗模式和生存率。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-23 DOI: 10.1245/s10434-024-16258-w
Carolin Siech, Mario de Angelis, Francesco Di Bello, Natali Rodriguez Peñaranda, Jordan A Goyal, Zhe Tian, Fred Saad, Shahrokh F Shariat, Stefano Puliatti, Nicola Longo, Alberto Briganti, Séverine Banek, Philipp Mandel, Luis A Kluth, Felix K H Chun, Pierre I Karakiewicz

Background: This study aimed to examine clinicopathologic characteristics, treatment patterns, and survival rates in a contemporary population-based cohort of adult prostate sarcoma patients.

Methods: In the Surveillance, Epidemiology, and End Results database (2004-2020), adult patients with prostate sarcoma were identified. Descriptive statistics, Kaplan-Meier analyses, smoothed cumulative incidence plots, and Cox regression models were used.

Results: Of 125 patients, 45 (36%) harbored leiomyosarcoma, 17 (14%) had rhabdomyosarcoma, 15 (12%) had stromal sarcoma, 17 (14%) had sarcoma not otherwise specified (NOS), and 31 (25%) had other sarcoma subtypes. Metastatic stage was most common in the rhabdomyosarcoma patients (44%) and least common in the leiomyosarcoma (21%) and stromal sarcoma (20%) patients. Most of the rhabdomyosarcoma patients received the combination of systemic and radiation therapy with (24%) or without radical surgery (35%), whereas most of the leiomyosarcoma and stromal sarcoma patients underwent radical surgery with (22 and 13%) or without (22 and 47%) radiation. In the overall population, the median overall survival was 27 months. The 5-years overall versus cancer-specific versus other-cause mortality rates were respectively 71 versus 58 versus 13%. In the multivariable Cox regression models, the highest overall mortality was exhibited by the patients with metastatic disease (hazard ratio [HR] 2.87; 95% confidence interval [CI] 1.55-5.31; p < 0.001) or unknown disease stage (HR 2.94; 95% CI 2.20-7.21; p = 0.019). Conversely, of all the histologic subtypes, only stromal sarcoma distinguished itself by lower overall mortality (HR 0.41; 95% CI 0.18-0.96; p = 0.039).

Conclusions: Four major histologic subtypes were identified. Among most adult sarcoma patients, treatment patterns vary according to histology, from multimodal therapy to radical prostatectomy alone. These treatment differences reflect equally important heterogeneity in survival patterns.

背景:本研究旨在研究当代人群中成年前列腺肉瘤患者的临床病理特征、治疗模式和生存率:本研究旨在研究当代基于人群的成年前列腺肉瘤患者队列的临床病理特征、治疗模式和存活率:方法:在监测、流行病学和最终结果数据库(2004-2020 年)中确定了成年前列腺肉瘤患者。使用了描述性统计、卡普兰-梅耶分析、平滑累积发病率图和 Cox 回归模型:在125名患者中,45人(36%)罹患横纹肌肉瘤,17人(14%)罹患横纹肌肉瘤,15人(12%)罹患间质肉瘤,17人(14%)罹患未另作说明的肉瘤(NOS),31人(25%)罹患其他亚型肉瘤。转移期在横纹肌肉瘤患者中最常见(44%),在亮肌肉瘤(21%)和间质肉瘤(20%)患者中最少见。大多数横纹肌肉瘤患者接受了全身治疗和放射治疗相结合的治疗(24%),或未接受根治性手术(35%),而大多数亮肌肉瘤和间质肉瘤患者接受了根治性手术,并接受了放射治疗(22%和 13%)或未接受放射治疗(22%和 47%)。总生存期的中位数为 27 个月。5年总死亡率、癌症特异性死亡率和其他原因死亡率分别为71%、58%和13%。在多变量考克斯回归模型中,转移性疾病(危险比 [HR] 2.87;95% 置信区间 [CI] 1.55-5.31;p < 0.001)或疾病分期不明(HR 2.94;95% CI 2.20-7.21;p = 0.019)患者的总死亡率最高。相反,在所有组织学亚型中,只有间质肉瘤的总体死亡率较低(HR 0.41;95% CI 0.18-0.96;P = 0.039):结论:研究发现了四种主要的组织学亚型。在大多数成人肉瘤患者中,治疗模式因组织学而异,从多模式治疗到单纯前列腺癌根治术。这些治疗差异反映出生存模式的异质性也同样重要。
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引用次数: 0
ASO Author Reflections: Breast-Conserving Surgery After Neoadjuvant Systemic Therapy for Early-Stage Breast Cancer: Quantitative Biomarkers and Disparities in the Precision-Medicine Era. ASO 作者反思:早期乳腺癌新辅助系统治疗后的保乳手术:精准医疗时代的定量生物标志物与差异。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-23 DOI: 10.1245/s10434-024-16265-x
Jincong Q Freeman, Dezheng Huo, Frederick M Howard

In this era of precision medicine, incorporating quantitative measures of estrogen receptor (ER)/progesterone receptor (PR)/Ki-67 expressions and genomic assays could more precisely identify neoadjuvant systemic therapy with the highest likelihood of response and tumor downstaging. In our recent study, we quantified the likelihood of achieving breast-conserving surgery (BCS vs. mastectomy) after neoadjuvant chemotherapy or endocrine therapy as a function of demographics, quantitative ER/PR/Ki-67 expressions, 21-gene recurrence scores, or 70-gene risk scores in early-stage, hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Using the 2010-2020 National Cancer Database, we found that the BCS rate after neoadjuvant chemotherapy was higher among patients with high 21-gene recurrence scores, lower ER/PR expression, or higher Ki-67 expression. Most patients who received neoadjuvant endocrine therapy underwent BCS, which was mostly dependent on ER expression. Asian women were less likely than white women to undergo BCS after neoadjuvant treatments. Lack of health insurance was associated with lower odds of BCS in both neoadjuvant settings. Although our study provides insight into the associations of BCS with quantitative biomarkers at a single time point, several questions remain unanswered. With the evolving landscape of neoadjuvant therapies in development for HR-positive/HER2-negative breast cancer, ongoing work using quantitative biomarkers and genomic assay scores is needed to select the right neoadjuvant systemic therapy for the right patient. Given the increasing amount of data available at the time of breast cancer diagnosis, novel computational approaches are needed to integrate patient demographic and tumor-specific factors to predict the optimal treatment strategy and likelihood of BCS.

在这个精准医疗的时代,结合雌激素受体(ER)/孕激素受体(PR)/Ki-67表达的定量测量和基因组检测,可以更精确地确定最有可能产生反应和肿瘤降期的新辅助系统性疗法。在我们最近的研究中,我们量化了早期激素受体(HR)阳性/人表皮生长因子受体2(HER2)阴性乳腺癌患者在接受新辅助化疗或内分泌治疗后接受保乳手术(BCS vs. 乳房切除术)的可能性,并将其作为人口统计学、ER/PR/Ki-67定量表达、21基因复发评分或70基因风险评分的函数。利用 2010-2020 年全国癌症数据库,我们发现在 21 基因复发评分较高、ER/PR 表达较低或 Ki-67 表达较高的患者中,接受新辅助化疗后的 BCS 率较高。大多数接受新辅助内分泌治疗的患者都进行了BCS,这主要取决于ER的表达。与白人女性相比,亚裔女性在接受新辅助治疗后接受BCS的可能性较低。在两种新辅助治疗中,缺乏医疗保险与较低的BCS几率有关。尽管我们的研究深入探讨了 BCS 与单个时间点定量生物标志物的关系,但仍有几个问题没有得到解答。随着HR阳性/HER2阴性乳腺癌新辅助疗法的不断发展,我们需要不断利用定量生物标志物和基因组检测评分来为合适的患者选择合适的新辅助系统疗法。鉴于乳腺癌诊断时可获得的数据量不断增加,需要采用新型计算方法来整合患者人口统计学和肿瘤特异性因素,以预测最佳治疗策略和BCS的可能性。
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引用次数: 0
ASO Author Reflections: Can Adequate Surgical Margin Rates after Mastectomy Be Improved? ASO 作者的思考:能否提高乳房切除术后的适当手术边缘率?
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-12 DOI: 10.1245/s10434-024-16312-7
Nicolás Ajkay
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引用次数: 0
ASO Author Reflections: Can Artificial Intelligence Assist in the Recognition of Recurrent Laryngeal Nerve During Robot-Assisted Minimally Invasive Esophagectomy? ASO 作者的思考:人工智能能否帮助识别机器人辅助微创食管切除术中的复发性喉神经?
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-29 DOI: 10.1245/s10434-024-16273-x
Tasuku Furube, Masashi Takeuchi, Hirofumi Kawakubo, Satoru Matsuda, Yuko Kitagawa
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引用次数: 0
Laparoscopic Parenchymal-Sparing Hepatectomy with Middle Hepatic Vein Resection and Reconstruction for Colorectal Liver Metastases: A Video Case Report. 腹腔镜肝实质保留肝切除术与肝中静脉切除和重建术治疗结直肠肝转移瘤:视频病例报告。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-23 DOI: 10.1245/s10434-024-16063-5
Yi Ting Lin, Tiing Foong Siow, Alvin Yong Hui Tan, Ian Chik, Kuo Hsin Chen
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引用次数: 0
Clinical Outcomes Between Completion and Abandonment of Radical Hysterectomy in Early-Stage Cervical Cancer Patients with Lymph Nodal Involvement Identified During Surgery: A Systematic Review and Meta-Analysis. 手术中发现淋巴结受累的早期宫颈癌患者完成和放弃根治性子宫切除术的临床结果:系统回顾与元分析》。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-07 DOI: 10.1245/s10434-024-16326-1
Hengxi Chen, Yali Chen, Ai Zheng, Xin Tan, Ling Han

Objective: This study aimed to summarize the clinical outcomes of early-stage cervical cancer patients with lymph node metastasis found during surgery who completed radical hysterectomy, or abandoned surgery and switched to chemoradiotherapy, in hopes of providing evidence for clinical treatment.

Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), and ClinicalTrials.gov databases were searched from inception to 20 November 2023. The analysis was conducted using STATA 16.0.

Results: A total of eight studies with 2105 early-stage cervical cancer patients were included in this review. Meta-analysis found no significant difference between the completing radical hysterectomy surgery (CRS) group and the abandoning radical surgery (ARS) group regarding overall survival (OS; hazard ratio [HR] 1.35, 95% confidence interval [CI] 0.93-1.97; I2 = 27.2%, p = 0.221), progression-free survival (PFS; HR 0.39, 95% CI 0.14-1.07; I2 = 0.0%, p = 0.625) and disease-free survival (DFS; HR 0.61, 95% CI 0.13-2.84; I2 = 0.0%, p = 0.574). Meta-analysis found the total recurrence (risk ratio [RR] 0.49, 95% CI 0.30-0.79; I2 = 0.0%, p = 0.810) and pelvic recurrence (RR 0.39, 95% CI 0.17-0.91; I2 = 12.4%, p = 0.320) in the CRS group were less than those in the ARS group. Meta-analysis found that compared with the ARS group, the CRS group had fewer grade 3/4 adverse effects (RR 0.58, 95% CI 0.41-0.82; I2 = 0.0%, p = 0.591).

Conclusions: Current evidence suggests that for early-stage cervical cancer patients with positive lymph nodes detected during surgery, CRS and ARS have similar survival outcomes, but completing radical surgery results in a lower incidence of pelvic recurrence.

Protocol registration: CRD42023480118.

研究目的本研究旨在总结手术中发现淋巴结转移的早期宫颈癌患者完成根治性子宫切除术或放弃手术改用化放疗的临床疗效,希望为临床治疗提供证据:方法:对 PubMed、Embase、Cochrane 对照试验中央注册中心 (CENTRAL)、国际临床试验注册平台 (ICTRP) 和 ClinicalTrials.gov 数据库中从开始到 2023 年 11 月 20 日的数据进行了检索。分析使用 STATA 16.0 进行:本综述共纳入了 8 项研究,涉及 2105 名早期宫颈癌患者。Meta 分析发现,完成根治性子宫切除手术(CRS)组与放弃根治性手术(ARS)组在总生存率(OS;危险比 [HR] 1.35,95% 置信区间 [CI] 0.93-1.97;I2 = 27.2%,P = 0.221)、无进展生存期(PFS;HR 0.39,95% CI 0.14-1.07;I2 = 0.0%,P = 0.625)和无病生存期(DFS;HR 0.61,95% CI 0.13-2.84;I2 = 0.0%,P = 0.574)。Meta分析发现,CRS组的总复发率(风险比[RR] 0.49,95% CI 0.30-0.79;I2 = 0.0%,P = 0.810)和盆腔复发率(RR 0.39,95% CI 0.17-0.91;I2 = 12.4%,P = 0.320)低于ARS组。Meta 分析发现,与 ARS 组相比,CRS 组的 3/4 级不良反应较少(RR 0.58,95% CI 0.41-0.82;I2 = 0.0%,p = 0.591):目前的证据表明,对于手术中发现淋巴结阳性的早期宫颈癌患者,CRS和ARS具有相似的生存结果,但完成根治术后盆腔复发的发生率更低:CRD42023480118。
{"title":"Clinical Outcomes Between Completion and Abandonment of Radical Hysterectomy in Early-Stage Cervical Cancer Patients with Lymph Nodal Involvement Identified During Surgery: A Systematic Review and Meta-Analysis.","authors":"Hengxi Chen, Yali Chen, Ai Zheng, Xin Tan, Ling Han","doi":"10.1245/s10434-024-16326-1","DOIUrl":"10.1245/s10434-024-16326-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to summarize the clinical outcomes of early-stage cervical cancer patients with lymph node metastasis found during surgery who completed radical hysterectomy, or abandoned surgery and switched to chemoradiotherapy, in hopes of providing evidence for clinical treatment.</p><p><strong>Methods: </strong>The PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), and ClinicalTrials.gov databases were searched from inception to 20 November 2023. The analysis was conducted using STATA 16.0.</p><p><strong>Results: </strong>A total of eight studies with 2105 early-stage cervical cancer patients were included in this review. Meta-analysis found no significant difference between the completing radical hysterectomy surgery (CRS) group and the abandoning radical surgery (ARS) group regarding overall survival (OS; hazard ratio [HR] 1.35, 95% confidence interval [CI] 0.93-1.97; I<sup>2 </sup>= 27.2%, p = 0.221), progression-free survival (PFS; HR 0.39, 95% CI 0.14-1.07; I<sup>2 </sup>= 0.0%, p = 0.625) and disease-free survival (DFS; HR 0.61, 95% CI 0.13-2.84; I<sup>2 </sup>= 0.0%, p = 0.574). Meta-analysis found the total recurrence (risk ratio [RR] 0.49, 95% CI 0.30-0.79; I<sup>2 </sup>= 0.0%, p = 0.810) and pelvic recurrence (RR 0.39, 95% CI 0.17-0.91; I<sup>2 </sup>= 12.4%, p = 0.320) in the CRS group were less than those in the ARS group. Meta-analysis found that compared with the ARS group, the CRS group had fewer grade 3/4 adverse effects (RR 0.58, 95% CI 0.41-0.82; I<sup>2 </sup>= 0.0%, p = 0.591).</p><p><strong>Conclusions: </strong>Current evidence suggests that for early-stage cervical cancer patients with positive lymph nodes detected during surgery, CRS and ARS have similar survival outcomes, but completing radical surgery results in a lower incidence of pelvic recurrence.</p><p><strong>Protocol registration: </strong>CRD42023480118.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"8954-8960"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Laparoscopic Duodenum and Spleen-Preserving Subtotal or Total Pancreatectomy: A Parenchyma-Sparing Strategy for Main Duct Intraductal Papillary Mucinous Neoplasms (with Video). 腹腔镜十二指肠和脾脏保留次全或全胰切除术:主导管内乳头状黏液性肿瘤的实质保留策略(附视频)。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-23 DOI: 10.1245/s10434-024-16244-2
Zheng Li, Yihua Shi, Wenjie Tang, Chen Chen, Wensheng Liu, Qifeng Zhuo, Shunrong Ji, Chenjie Zhou, Xianjun Yu, Xiaowu Xu

Background: For premalignant main duct intraductal papillary mucinous neoplasms (MD-IPMN), laparoscopic duodenum and spleen-preserving subtotal or total pancreatectomy (LDSP-STP/TP) seems to be a viable option for parenchyma-sparing pancreatectomy.

Patients and methods: On the basis of the imaging features, family history, genomic alterations, intraoperative ultrasound examination, and frozen section evaluation, we have proposed patient selection strategies for the LDSP-STP/TP technique for the first time. Additionally, a comprehensive step-by-step overview of this technique has been provided. To date, we have performed five LDSP-STP procedures and one LDSP-TP procedure.

Results: We successfully performed selective resection of the affected pancreatic parenchyma while preserving the duodenum, common bile duct (CBD), spleen, and splenic artery and vein. The operation time ranged from 295 to 495 min, with blood loss ranging from 100 to 300 mL. Postoperative pathological results revealed low-grade dysplasia in the resected pancreatic samples and margins. The patients resumed eating within 3-5 days after surgery, and all postoperative complications were classified as grade I according to the Clavien-Dindo classification. At the 3-month follow-up, there were no cases of CBD ischemic stenosis, splenic ischemia, or pseudocyst formation observed. For patients who received LDSP-STP, the longitudinal diameter of the remaining pancreatic tail ranged from 2.2 to 4.6 cm, and they demonstrated satisfactory long-term blood glycemic control.

Conclusions: LDSP-STP/TP demonstrates technical feasibility and safety. It allows for the selective resection of the affected pancreatic parenchyma, thereby minimizing the impact of pancreatic functional impairment. However, it is crucial to validate this technique through long-term prospective observations.

背景:对于前恶性主导管内乳头状黏液瘤(MD-IPMN),腹腔镜十二指肠和脾脏保留次全或全胰腺切除术(LDSP-STP/TP)似乎是保留胰腺实质切除术的可行选择:根据影像学特征、家族史、基因组改变、术中超声检查和冰冻切片评估,我们首次提出了 LDSP-STP/TP 技术的患者选择策略。此外,我们还提供了该技术的全面步骤概述。迄今为止,我们已经实施了五例 LDSP-STP 手术和一例 LDSP-TP 手术:结果:我们成功地对受影响的胰腺实质进行了选择性切除,同时保留了十二指肠、胆总管(CBD)、脾脏、脾动静脉。手术时间为 295 至 495 分钟,失血量为 100 至 300 毫升。术后病理结果显示,切除的胰腺样本和边缘存在低度发育不良。患者在术后 3-5 天内恢复进食,根据 Clavien-Dindo 分级法,所有术后并发症均为 I 级。在 3 个月的随访中,没有发现 CBD 缺血性狭窄、脾脏缺血或假性囊肿形成的病例。接受LDSP-STP治疗的患者,剩余胰尾的纵向直径在2.2厘米至4.6厘米之间,长期血糖控制令人满意:结论:LDSP-STP/TP具有技术可行性和安全性。结论:LDSP-STP/TP 证明了技术的可行性和安全性,它可以选择性切除受影响的胰腺实质,从而将胰腺功能障碍的影响降至最低。然而,通过长期前瞻性观察来验证这项技术至关重要。
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引用次数: 0
SDHB-Associated Pheochromocytomas: What is Their Clinical Behavior? SDHB 相关嗜铬细胞瘤:它们的临床表现如何?
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-09 DOI: 10.1245/s10434-024-16120-z
Thomas Szabo Yamashita, Andres Tame-Elorduy, Catherine M Skefos, Jeena M Varghese, Mouhammed Amir Habra, Sarah B Fisher, Paul H Graham, Elizabeth G Grubbs, Steven G Waguespack, Camilo Jimenez, Nancy D Perrier

Introduction: Germline pathogenic variants in succinate dehydrogenase subunit B (SDHB) cause paraganglioma/pheochromocytoma syndrome type 4 (PGL-4). SDHB-associated pheochromocytomas (PCC) are thought to be rare and little data exist about their clinical behavior.

Patients and methods: Retrospective review of patients treated (1993-2023) at a tertiary cancer center for SDHB-associated PCC. Clinical and demographic variables were retrieved to characterize disease-free survival, disease progression, and overall survival.

Results: In total, 90 SDHB-carriers were identified, 18% had PCC (n = 16). Median age at diagnosis of was 40 (19-76) years, 50% (n = 8) of patients were male, 25% (n = 4) had distant metastasis (DM) at diagnosis, and 13% (n = 2) had synchronous PGL. No patients had bilateral disease, and 94% of patients underwent surgery as initial treatment with a curative intent in 75%. Overall, 64% of patients underwent open resection. Recurrence occurred in 77% of patients (n = 10), 75% in minimally invasive surgery (MIS) versus 77% open, p = 0.63. Bone was the most common site of DM (100%, n = 13). Metaidobenzyleguanidine (MIBG) imaging was performed in 69% of patients, 91% of which were positive. Median time from surgery until recurrence was 36 months (1-295 months). Radiation therapy was the most common adjuvant treatment (44%) followed by Iobenguane I-131 (31%) and systemic therapy (31%). Median follow-up time was 56 months (1-408 months). Overall, 33% of patients were alive, 19% of patients were disease-free, and 50% of the patients with DM had stable disease at last follow-up.

Conclusions: Overall, 18% of germline SDHB mutation-carriers were diagnosed with PCC, all of which were unilateral. SDHB-associated PCC was associated with advanced and recalcitrant disease and was often MIBG positive. More studies are needed to better understand the clinical behavior of PCC in PGL-4.

导言:琥珀酸脱氢酶亚基B(SDHB)的基因致病变异会导致副神经节瘤/嗜铬细胞瘤综合征4型(PGL-4)。SDHB相关嗜铬细胞瘤(PCC)被认为是罕见的,有关其临床表现的数据也很少:患者和方法:对在一家三级癌症中心接受 SDHB 相关嗜铬细胞瘤治疗的患者(1993-2023 年)进行回顾性研究。检索临床和人口统计学变量,以确定无病生存期、疾病进展和总生存期的特征:共发现90名SDHB携带者,其中18%患有PCC(n = 16)。诊断时的中位年龄为40(19-76)岁,50%(n = 8)的患者为男性,25%(n = 4)的患者诊断时有远处转移(DM),13%(n = 2)的患者有同步PGL。没有患者患有双侧疾病,94%的患者接受了手术作为初始治疗,75%的患者接受了治愈性治疗。总体而言,64%的患者接受了开放性切除术。77%的患者(n = 10)出现复发,微创手术(MIS)的复发率为75%,而开放手术的复发率为77%,P = 0.63。骨是 DM 最常见的部位(100%,n = 13)。69%的患者进行了甲苯乙胍(MIBG)成像,其中91%呈阳性。从手术到复发的中位时间为36个月(1-295个月)。放射治疗是最常见的辅助治疗方法(44%),其次是碘本胍 I-131(31%)和全身治疗(31%)。中位随访时间为56个月(1-408个月)。总体而言,33%的患者存活,19%的患者无病,50%的DM患者在最后一次随访时病情稳定:结论:总体而言,18%的种系SDHB突变携带者被确诊为PCC,所有患者均为单侧。SDHB相关的PCC与晚期和顽固性疾病有关,并且通常呈MIBG阳性。要更好地了解 PGL-4 中 PCC 的临床表现,还需要进行更多的研究。
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引用次数: 0
Correlation Between the Number of Pathological Risk Factors and Postoperative Prognosis in Patients with Stage I Lung Adenocarcinoma. 肺腺癌 I 期患者病理风险因素数量与术后预后之间的相关性
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-19 DOI: 10.1245/s10434-024-16045-7
Junhong Liu, Bingji Cao, ZhiHua Shi, Xinbo Liu, Junfeng Liu

Background: Although visceral pleural invasion, lymphovascular invasion, tumor spread through air spaces, and poor differentiation are pathological risk factors associated with unfavorable prognosis in patients with lung adenocarcinoma, the cumulative impact of these factors on prognosis remains unclear.

Methods: We enrolled 1532 patients with stage I lung adenocarcinoma. Patients were divided according to the number of risk factors as follows: Group A (without risk factors), Group B (one risk factor), and Group C (multiple risk factors). Moreover, we stratified patients into two subgroups based on tumor size (≤ 3 cm, 3-4 cm). Kaplan-Meier analysis was used to evaluate 5-year disease-free survival (DFS) and overall survival (OS).

Results: Overall, 949, 404, and 179 patients were included in Groups A, B, and C, respectively. Group C had a larger tumor size and more cases of extrathoracic recurrence than the other groups. The 5-year DFS and OS gradually decreased across Groups A to C (DFS: 94.3%, 80.6%, and 64.3%, respectively, p < 0.001; OS: 97.2%, 92.7%, and 77%, respectively, p < 0.001). A similar trend was observed for tumors ≤ 3 cm in size (DFS: 95.2%, 83.2%, and 68.5%, respectively, p < 0.001; OS: 97.6%, 94.1%, and 79.6%, respectively, p < 0.001), but a less pronounced trend was observed for tumors between 3 and 4 cm in size (DFS: 72.1, 60.8, and 43.3%, respectively, p = 0.054; OS: 85.7, 82.1, and 64.7%, respectively, p = 0.16).

Conclusions: Postoperative survival worsened with increasing pathological risk factors in patients with stage I lung adenocarcinoma, especially those with tumor size ≤ 3 cm.

背景:虽然内脏胸膜侵犯、淋巴管侵犯、肿瘤通过气隙扩散和分化不良是与肺腺癌患者预后不良相关的病理风险因素,但这些因素对预后的累积影响仍不清楚:我们招募了 1532 名 I 期肺腺癌患者。根据风险因素的数量将患者分为以下几组:A组(无危险因素)、B组(一个危险因素)和C组(多个危险因素)。此外,我们还根据肿瘤大小(≤ 3 厘米、3-4 厘米)将患者分为两个亚组。我们采用卡普兰-梅耶尔分析法评估患者的5年无病生存期(DFS)和总生存期(OS):A 组、B 组和 C 组患者分别为 949 人、404 人和 179 人。与其他组相比,C组肿瘤体积更大,胸外复发病例更多。A 组到 C 组的 5 年 DFS 和 OS 逐渐下降(DFS:分别为 94.3%、80.6% 和 64.3%,P,结论):I期肺腺癌患者的术后生存率随着病理危险因素的增加而恶化,尤其是肿瘤大小≤3厘米的患者。
{"title":"Correlation Between the Number of Pathological Risk Factors and Postoperative Prognosis in Patients with Stage I Lung Adenocarcinoma.","authors":"Junhong Liu, Bingji Cao, ZhiHua Shi, Xinbo Liu, Junfeng Liu","doi":"10.1245/s10434-024-16045-7","DOIUrl":"10.1245/s10434-024-16045-7","url":null,"abstract":"<p><strong>Background: </strong>Although visceral pleural invasion, lymphovascular invasion, tumor spread through air spaces, and poor differentiation are pathological risk factors associated with unfavorable prognosis in patients with lung adenocarcinoma, the cumulative impact of these factors on prognosis remains unclear.</p><p><strong>Methods: </strong>We enrolled 1532 patients with stage I lung adenocarcinoma. Patients were divided according to the number of risk factors as follows: Group A (without risk factors), Group B (one risk factor), and Group C (multiple risk factors). Moreover, we stratified patients into two subgroups based on tumor size (≤ 3 cm, 3-4 cm). Kaplan-Meier analysis was used to evaluate 5-year disease-free survival (DFS) and overall survival (OS).</p><p><strong>Results: </strong>Overall, 949, 404, and 179 patients were included in Groups A, B, and C, respectively. Group C had a larger tumor size and more cases of extrathoracic recurrence than the other groups. The 5-year DFS and OS gradually decreased across Groups A to C (DFS: 94.3%, 80.6%, and 64.3%, respectively, p < 0.001; OS: 97.2%, 92.7%, and 77%, respectively, p < 0.001). A similar trend was observed for tumors ≤ 3 cm in size (DFS: 95.2%, 83.2%, and 68.5%, respectively, p < 0.001; OS: 97.6%, 94.1%, and 79.6%, respectively, p < 0.001), but a less pronounced trend was observed for tumors between 3 and 4 cm in size (DFS: 72.1, 60.8, and 43.3%, respectively, p = 0.054; OS: 85.7, 82.1, and 64.7%, respectively, p = 0.16).</p><p><strong>Conclusions: </strong>Postoperative survival worsened with increasing pathological risk factors in patients with stage I lung adenocarcinoma, especially those with tumor size ≤ 3 cm.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"9310-9320"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Annals of Surgical Oncology
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