Department of Oral Immunology,School of Stomatology,Shanghai No.9 Hospital,Shanghai Second Medical University.Shanghai 200011, China.
Malignant melanoma is a kind of tumor with higher malignant and lower therapeutic effect.it is demonstrated by experiment that melanoma cells have antigenicity and refer to immunology.BCG is a kind of biologic response modifier(BRM).it is able to promote physical antitumor ability.There were 42 patients with oral and maxillofacial malignant melanoma who received freezing therapy and surgery in this paper.11 cases of them added BCG immunotherapy.The result is that the median survival time of therapy plus BCG group is 4 years,and 3 years,5 years,7 years survival rate are 89%,72% and 32%,over 8 years survival rate is 18%.The median survival time of another group is 2 years,and 3 years,5 years,7 years survival rate are 55%,24% and 12%,over 8 years survival rate is 3%.There is a statistically significant difference between these two groups and BCG group has a longer survival time.This preliminary study demonstrated that BCG adjuvant therapy could decrease recurrence of metastases and increase patients survival time.
Other papers by authors:
[Effect of Chinese traditional prescription "Shen Yang" on the immune function of oral squamous cells carcinoma patients.].
Department of Oral Immunology,School of Stomatology,Shanghai Second Medical University. Shanghai 200011, China.
This report tries to compare the immunologic function of being take the Chinese medicine "Fu-Fang Shen Yang" or placebo C which is based on randomized clinical trials after operation for 238 cases of oral squamous cancer.DNCB test is for observable index.The results as follows:DNCB position rate of 1 "Shen Yang" group is significantly increased to compare with the placebo C group,after 3m(P<0.01) 6m (P<0.001).Two groups are significantly increased after one year.This suggestion that "Fu-Fang Shen Yang" can enhance immunologic function after operation fro oral squamous cells carcinoma patients.
[The Chinese traditional treatment with "ShengYang" prescription as a post-operative auxiliary method using on the oral squamous cells carcinoma patients.].
Department of Traditional Chinese Medicine, Ninth People's Hospital, School of Stomatology,Shanghai Second Medical University. Shanghai 200011, China.
This paper observed the clinic investigation.Which prove the relationship among the Chinese dialectical fur condition pulse condition,dialectical divided into types and survival time,immunity function before and after therapy,which will provide scientific basis and new train of thinking for recovery of stomatological carcinoma patient following operation.These patients according to dialectical type.were divided into type of feeble kidney and type of mixed excess and deficiency syndrome that the survive time compare with control group through treat by statistics,were P<0.05.The positive cases of immunity response of administration group were more increased than control group, the rate was 22.2%,maintenance and decrease rate were 7.5% and 14.6% compare with control group,with multiple factor computer analysis in two groups.There is some evidence that the traditional Chinese prescription of "ShengYang" treat in tumor patients with the type of feeble kidney and type of mixed excess an deficiency syndrome were remarkably regulate the immunity function and promote the action of anti tumor.For recovery therapy after tumor operation which reach a fairly action.
Department of Oral Immunity,School of Stomatology,Shanghai Second Medical University. Shanghai 200011, China.
[Evaluation of cryosurgery for the management of oral malignant mucomembranous melanoma-A survey of 107 cases reports]
Departmentof Oral & Maxillofacial Surgery,School of Stomatology,Shanghai Second Medical University. Shanghai 200011,China.
OBJECTIVE:There were 13 cases underwent operation.24 cases underwent cryosurgery only and 70 cases received comprehensive management,which as cryosurgery,operation,chemotherapy and immuno-therapy.RESULTS:The 3'and 5' year survival rate of three groups were 0.0%,0.0%,37.50%,31.25% and 57.14%,36.07%.There are significant differences between operation group and cryosurgery group and between operation group and comprehensive treatment group.Although the third group got the better result,but the difference between late two groups was not statistical significant.CONCLUSION:It is suggested that comprehensive treatment be the routine regime of melanoma in head and neck. Our experience with review of literature covered the classification, surgical principle and complication was presented.
[A randomized clinical trial for the evaluation of head and neck squamous cell carcinoma treating with traditional Chinese medicine]
Department of Oral Immunology,School of Stomatology,Shanghai Second Medical University. Shanghai 200011, China.
This paper described the research design,research process and statistical analysis of randomized clinical trial by treatment with traditional Chinese medicine in patients with squamous cell carcinoma of the head and neck.At first we found there was no significant difference between treating group and contral group(P>0.05) using log-rank test on Kaplan-Meier survival curves. With further multivariate analysis Cox model and after adjusting for sex,age,legth of taking the assigned medication,grade of tumor differentiation and using of chemotherapy,the rate of tumor-related death for control group was significantly higher than that for treating group :hazards ratio estimate was 1.939(95% confidence interval 1.008-3.729,(P<0.05).The length of taking Chinese medicine was one of the most important prognostic factors(P<0.001).The results suggest that the prescribed medication contributed to the improved survival,and it was an independent prognostic factor.
Department of Oral and Maxillofacial Surgery,Affiliated Ninth People's Hospital,Shanghai Second Medical University. Shanghai 200011,China.
Department Of Oral Maxillofacial Surgery, Ninth People's Hospital, Shanghai Second Medical University, Shanghai 200011, China.
OBJECTIVE In order to search a safer argon laser photodynamic method, this study used 488 nm wavelength and common mixed spectrum argon laser PDT for treating Port Wine Stain. The therapeutic effects and side effect were compared. METHODS Fifty two cases of PWS were divided into two groups randomly. Argon laser PDT by two ways of laser irradiation were used. RESULTS Our data revealed 19.23% cure rate in 488 nm laser PDT group, while that of mixed wavelength laser group was 11.54%. There was no significant difference in the two groups. Also the effective rate of 488 nm laser group was 92.31% and that of mixed group was 88.46%. But the difference was not significant statistically. Side effect occurred often in mixed spectrum laser group. That was 57.69% for mixed group, 38.46% for 488 nm group. CONCLUSION Argon laser PDT at 488 nm had the similar therapeutic result contrasted to mixed spectrum laser group, but it was safe.
Dept.of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Dept. of Gastroenterology & Hepatology, University Medicine Cluster, National University Health System, Singapore Brain-Gut Research Group, Bern, Switzerland.
Background Visceral hypersensitivity is one of the proposed underlying mechanisms in functional dyspepsia (FD). It is not clear whether visceral hypersensitivity in FD is a manifestation of a central sensitization also encompassing somatic sensitization. Transient receptor potential vanilloid-1 (TRPV(1)) pathways are involved in gastric mechanosensory physiology and the TRPV(1) receptor agonist, capsaicin, has been used as a chemical stimulant. Methods In this double-blind, randomized study we evaluated both visceral and somatic sensory function in 34 FD patients and 42 healthy controls using quantitative sensory testing. Visceral pain sensitivity was assessed using a validated gastric pain model with oral capsaicin capsule titration and somatic pain sensitivity was determined by foot heat and hand electric stimulation. Key Results The median capsaicin dose required to attain moderate pain was 0.5mg in FD and 1mg in controls (P = 0.03). At these doses, mean pain intensities on a 0-100 visual analog scale were greater for FD than controls [56.9 (95% confidence intervals, 52.2-61.5) vs 45.1 (41.6-48.6), resp.](P = 0.005). Overall, mean somatic sensory and pain thresholds were similar in FD and control groups, but in a subgroup of FD pain hypersensitivity was seen on the hand and on the foot at different stimulation thresholds. Conclusions & Inferences A majority of patients with FD have visceral chemo-hypersensitivity involving TRPV(1) pathways. A substantial subgroup also has somatic hypersensitivity as evidence of central sensitization.
Distribution of regulatory T cells and interaction with dendritic cells in the synovium of rheumatoid arthritis.
Department of Orthopaedics, The First Affiliated Hospital of Harbin Medical University , Harbin , China.
Objectives: The aim of this study was to investigate the tissue distribution of regulatory T cells (Treg cells) and their interaction with dendritic cells (DCs) in synovium from patients with rheumatoid arthritis (RA) or osteoarthritis (OA). Methods: Immunohistochemical staining was used to investigate the distribution of Treg cells and the interaction between Treg cells and DCs in RA (n = 30) and OA synovium (n = 8). mRNA levels were measured by quantitative real-time reverse transcription polymerase chain reaction (RT-PCR). Results: Large numbers of Treg cells were observed in lymphoid aggregates and perivenular infiltration areas in the RA synovium. Specific cellular markers for Treg cells (Foxp3, CD39, LAG-3, and Nrp-1) were found in lymphoid aggregates, perivenular infiltration, and scattered in lining layer areas. As molecular markers for DCs, DC-LAMP, DEC-205, CD80/86, and CD83 were also detected in the lymphoid aggregates and perivenular infiltration areas in RA. Furthermore, the co-localization of Treg cells and DCs was confined mainly in the lymphoid aggregation areas. The number of DCs increased significantly more than the number of Treg cells with inflammatory progression in RA. mRNA expression of the cellular markers for Treg cells (Foxp3, LAG-3, and Nrp-1) and the molecular markers for DCs (DC-LAMP and DEC-205) was increased in RA compared with OA synovium. Conclusions: Our results indicate that DCs play a dominant role in regulating the activation and progression of immune responses in RA, even though the number of Treg cells was upregulated at the same time. This suggests that Treg cells do not function normally to suppress the maturation of DCs in the RA synovium.
Diabetes mellitus and the incidence and mortality of colorectal cancer: a meta-analysis of 24 cohort studies.
Center of Evidence Based Medicine, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China.
Aim The incidence and mortality of colorectal cancer (CRC) were quantified in persons with and without diabetes mellitus (DM). Method Medline and Embase were searched for articles published before July 2010. Cohort studies that evaluated incidence and mortality of DM and CRC were included. The initial search identified 1887 titles, of which 24 articles met the inclusion criteria. We defined the relative risk (RR) as the metric of choice; 95% confidence intervals (CIs) were calculated with a random-effects model. Results There was an increase in the RR of developing CRC in persons with DM compared with those without DM (RR 1.28; 95% CI 1.19-1.39), without heterogeneity between studies (P(heterogeneity) = 0.13). The association between duration of DM and CRC incidence was stronger in the 11-15-year group (RR 1.51; 95% CI 1.12-2.03) than in the <10-year group (RR 1.05; 95% CI 0.90-1.22) and the >15-year group (RR 1.25; 95% CI 0.80-1.94), and there was significant heterogeneity among subgroups (P(heterogeneity) = 0.01). In studies reporting standardized incidence ratios (SIRs), there was an increased incidence of CRC with DM (RR 1.27; 95% CI 1.14-1.42; P(heterogeneity) = 0.09), and the association was stronger among men (RR 1.47; 95% CI 1.15-1.86) than women (RR 1.08; 95% CI 1.00-1.17); there was significant heterogeneity among gender (P(heterogeneity) = 0.01). Conclusion This meta-analysis suggests that individuals with DM have a significant increase in risk of developing CRC.
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N Z Vet J. 2012 Aug 23;: 22913610
a Victorian Animal Cancer Care, 21 Goldsbrough Walk , Kensington , Victoria , 3031 , Australia.
Abstract AIMS: The aim of the study was to compare the effect of carboplatin chemotherapy on the survival of canine patients diagnosed with malignant melanoma after loco-regional control or as a sole therapy. METHODS: A retrospective study of 63 dogs with oral, digital or cutaneous malignant melanoma treated with surgery and/or chemotherapy was undertaken. Dogs were grouped based on the anatomical site of melanoma development. For oral melanoma, dogs were subclassified into two groups: loco-regional control and gross disease. All patients in the digital and cutaneous groups had achieved loco-regional control with surgery. Comparisons between survival data for each group at each anatomical site were then made. Within the loco-regional control groups survival time was compared between those treated with and without chemotherapy post surgery. For the oral melanoma patients with gross disease survival was compared between those treated with chemotherapy and palliative therapy. The toxicity of carboplatin chemotherapy was evaluated overall. RESULTS: The overall median survival times for patients with oral, digital and cutaneous melanoma were 389, 1,350 days and not reached (with a median follow-up of 776 days) respectively. Median survival time was defined as "not reached" when less than 50% of the subjects died of the disease at the end of the follow-up period, or at the time they were lost to follow-up. The addition of chemotherapy to surgery did not confer a survival benefit in the loco-regional control setting when assessing survival for each anatomical site. For oral melanoma patients with gross disease there was no difference between survival of patients treated with chemotherapy and palliative intent therapy. There was however an improvement in survival in the three dogs that responded to chemotherapy (978 days; p=0.039) compared to the eight non-responders (147 days). On univariate and multivariate analysis, anatomic location was the only variable that was significantly related to survival (p=0.0002 and p=0.009, respectively). CONCLUSIONS: The addition of chemotherapy to local treatments for canine melanoma at oral, digital and cutaneous sites did not lead to a significant increase in survival times. Carboplatin was well tolerated and appeared to have activity against oral melanoma in a subset of patients with gross disease that responded to treatment. CLINICAL RELEVANCE: Carboplatin with piroxicam could be considered for patients with gross disease when more traditional therapies, such as surgery or radiation therapy, are declined or are not available. In the loco-regional control setting, prospective randomised blinded studies with matched control groups are required to determine if chemotherapy has a role in the treatment of these types of cancer.
Vet Comp Oncol. 2011 May 2;: 22236095
S A Frazier, S M Johns, J Ortega, A L Zwingenberger, M S Kent, G M Hammond, C O Rodriguez Jr, M A Steffey, K A Skorupski
William R. Prichard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, CA, USA School of Veterinary Medicine, University of California-Davis, Davis, CA, USA Department of Surgical and Radiological Sciences, University of California-Davis, Davis, CA, USA.
Oral fibrosarcoma (FSA) is a common oral tumour in dogs, and historically reported survival times after surgical excision range from 7.0 to 12.2 months with local recurrence rates of 32-57%. The purpose of this retrospective study was to report outcome in a cohort of dogs with oral FSA treated with surgical excision with or without adjuvant radiation therapy. Twenty-nine dogs with a histological diagnosis of FSA arising from the oral cavity that underwent surgical resection of their oral FSA were included in this study. Twenty-one dogs were treated with surgical excision alone and eight dogs with both surgery and radiation therapy. The median progression-free interval was >653 days. The median survival time was 743 days. The 1- and 2-year survival rates were 87.7 and 57.8%, respectively. Seven (24.1%) dogs developed local recurrence. Seven dogs (24.1%) developed metastasis.
Outcome of medulloblastoma in children treated with reduced-dose radiation therapy plus adjuvant chemotherapy.
Nongnuch Sirachainan, Issarang Nuchprayoon, Pattra Thanarattanakorn, Samart Pakakasama, Apasri Lusawat, Anannit Visudibhan, Mantana Dhanachai, Noppadol Larbcharoensub, Jiraporn Amornfa, Kanchana Shotelersuk, Kamornwan Katanyuwong, Saipin Tangkaratt, Suradej Hongeng
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Medulloblastoma is the most common malignant brain tumor in children. Post-surgical craniospinal irradiation (CSI; 30-36 Gy) plus local boost radiation therapy (RT; 54-56 Gy) is a standard treatment for children with medulloblastoma who are over 3 years old, resulting in a 5-year overall survival (OS) rate of 46% to 65% in average-risk patients and 50% in high-risk patients. The addition of chemotherapy has the benefit of reducing complications from radiation and improving the OS rate. Using this approach, the estimated 5-year OS rates for patients with average- and high-risk medulloblastomas treated with different protocols are 65% to 85% and 16% to 70%, respectively. In this study, we determined the outcome of patients with average- and high-risk medulloblastomas treated with reduced dosage CSI and chemotherapy with an oral etoposide-based regimen. The study included 49 patients, with a mean age of 7.7 ± 3.4 years. Twenty-six patients (53%) were classified as average-risk and 23 patients (47%) as high-risk. In the average-risk group, the 5-year progression free survival (PFS) rate was 62.9% ± 10% and the 5-year OS rate was 70.4% ± 9.5%. In the high-risk group the 5-year PFS rate was 48.9% ± 13% and the 5-year OS rate was 49.7% ± 13%. In the average-risk group, patients who received CSI of either 24 Gy (n=20) or 36 Gy (n=9) showed no difference in their 5-year PFS and OS rates. We found that patients who were ≤ 10 years old and patients who were female had a significantly better 5-year PFS rate.
Colorectal Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China, firstname.lastname@example.org.
OBJECTIVE: Anorectal malignant melanoma (AMM) is frequently subjected to misdiagnosis. Here the effect of misdiagnosis on the prognosis of AMM was investigated. METHODS: Between 1995 and 2007, 79 patients managed for AMM were reviewed; 46 (58.23%) of them had been misdiagnosed during the symptoms, while 33 (41.77%) cases had been diagnosed exactly not more than 1 week after the first visit. Diseases misdiagnosed were categorized as cancer, hemorrhoids, polyps and other diseases. Data were statistically analyzed by using the life tables and Kaplan-Meier curves. The software used was SPSS 16.0 for Windows. RESULTS: The 1-, 2-, 3- and 5-year survival rates of AMM patients were 58, 33, 24 and 16%, respectively, and the median survival time was 14.0 months; 1-, 2-, 3- and 5-year survival rates of the misdiagnosed patients were 61, 22, 22 and 11%, respectively, and the median survival time was 14.0 months; 1-, 2-, 3- and 5-year survival rates of the patients not misdiagnosed were 55, 44, 25 and 25%, respectively, and the median survival time was 12.0 months. Analyses based on Kaplan-Meier curves revealed no significant effect of misdiagnosis on the survival of AMM patients (P > 0.05). Nevertheless, the diseases misdiagnosed significantly affect the prognosis (P = 0.009); AMM misdiagnosed as hemorrhoids had a poor prognosis, with a 1-year survival rate of only 29% and the median survival of only 6.0 months. CONCLUSIONS: The misdiagnosed patients had relatively poor prognosis, but the effect of misdiagnosis on the prognosis was not significant; however, misdiagnosis of AMM as hemorrhoids seriously affected the prognosis.
[Relationship between the expression of hypoxia-inducible factor-1alpha and chemotherapy response in gastric carcinoma].
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
OBJECTIVE To evaluate the relationship of hypoxia-inducible factor (HIF)-1alpha expression with chemotherapy response in gastric cancer and its clinical outcome. METHODS Leucovorin (CF) and 5-fluorouracil (5-FU) in combination with oxaliplatin (L-OHP) were used in 52 patients with gastric carcinoma (GC) at advanced stage. CF 200 mg/m(2) was intravenous drop for 2 h at day 1 and day 14. 5-FU 1500 mg/m(2) was continuously intravenous drop for 46 h at day 1 and day 14. L-OHP 85 mg/m(2) was intravenous drop for 2 h at day 1 and day 14. Four-week was one cycle. All the patients received 4 cycles of chemotherapy at least. Chemotherapy response and clinical outcome were evaluated. Immunohistochemistry was used to examine the protein expressions of HIF-1alpha, P-gp and MRP4 by tissue microarray in GC. Twenty-seven normal gastric tissue samples were used as control group. RESULTS The positive expression rates of HIF-lalpha, P-gp and MRP4 in tumor samples were 53.9%, 51.9% and 57.7% respectively, which were significantly higher than those in normal gastric tissues (0, 18.5% and 14.8% respectively)(P<0.05). In cases with positive expression of HIF-lalpha, the response rate was 14.3%; whereas in cases with negative expression of HIF-1alpha, the response rate was 50.0%. There was significant difference between two groups (P<0.05). In patients of HIF-1alpha positive expression,the median progression-free survival time was 4.7 months,the median survival time was 8.8 months, and 1-year, 2-year survival rates were 37.5% and 21.5% respectively. In patients of HIF-1alpha negative expression, the median progression-free survival time was 8.4 months, the median survival time was l2.6 months, and 1-year, 2-year survival rates were 51.2% and 33.5% respectively. There were significant differences between two groups (P<0.05). CONCLUSION HIF-1alpha expression may be a useful indicator to predict the chemotherapy response and clinical outcome in gastric carcinoma.
A Demir, A Sayar, C I Kocaturk, M Z Gunluoglu, H Akýn, M Metin, L Cansever, A Olcmen, S I Dincer, M A Bedirhan, A Gurses
Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
BACKGROUND: This study aims to investigate the treatment modalities and factors influencing survival in surgically treated superior sulcus tumors. PATIENTS AND METHOD: Sixty-five cases of surgically treated non-small cell carcinoma of the lung occurring as superior sulcus tumors between 1994 and 2007 were retrospectively reviewed. Twenty-five patients underwent induction radiotherapy (RT), 10 had induction chemoradiotherapy (CT/RT). In thirty patients surgery was performed directly. The mortality rate was 6.2 %. Pathological stage was T3 in 55, T4 in 10, N0 in 52, and N1 in 5 and N2 in 8 patients. RESULTS: Overall 5- and 10-year survival rates were 31 % and 28 %, respectively. Complete resection rate was 90 % for patients who received induction CT/RT and 80 % for patients who either received induction RT alone or patients in whom surgery was performed directly. In patients who received neoadjuvant therapy with complete tumor resection, the median survival time was 33 months (28 months for patients who received induction RT alone and 36 months for patients who received induction CT/RT), and the 5-year survival rate was 41 %. Median survival time and 5-year survival rate of patients treated by direct surgery with complete resection was 24 months and 37 %, respectively ( P = 0.87). Five-year survival and 10-year survival rates were significantly higher after complete resection than after incomplete resection (38 % and 34 % vs. 0 %, P = 0.0001). In multivariate analysis, only N2 disease ( P = 0.04) and incomplete resection ( P = 0.03) were found to be poor prognostic factors. CONCLUSION: The presence of N2 disease and incomplete resection are the two most important factors affecting survival. Induction CT/RT may increase the ability to achieve complete surgical resection.
Primary mucosal melanoma of the head and neck. Comparison of clinical presentation and histopathologic features of oral and sinonasal melanoma.
Department of Otolaryngology, Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA.
We reviewed all cases of head and neck mucosal melanomas (HNMM) treated at Emory University and affiliated hospitals during a 20 year period and evaluate overall survival, recurrences and efficacy of treatment. Comparisons were made between sinonasal melanoma (SNM) and oral cavity melanoma (OCM) including clinical features, histopathologic features, treatment, and clinical outcomes. We analyzed pathologic features and clinical outcomes of 22 cases of primary SNM and eight cases of OCM treated at Emory University Hospital between 1986 and 2006. Sixteen patients were stage I (53%), nine patients were stage II (30%) and five patients were stage III (17%). Mean age was 67.5 years with a range from 32 to 85 years. Sixty percent were men and 92% were white. The average follow-up time was 22.1 months and the median was 15.5 months. The average delay between onset of symptoms and diagnosis was 5.6 months. Patients with SNM had a lower incidence of nodal metastasis at initial presentation when compared with OCM (22% vs. 50%)(p<.08). Surgical resection was the primary treatment and was performed in 27/30 patients (90%). Two patients with SNM and 1 patient with OCM, because of advanced stage at diagnosis had no treatment. Radiation was used in 50%(15) of the patients and radiation as postoperative therapy was administered to 44.8%(13) of the patients. The combination of surgery, radiation and adjuvant therapy was administered to 39.2%(11/2 8) of the patients. The recurrence rate at the time of closing this study was 43.3%(13 patients) with a mean time for development of recurrences of 13.1 months. Twenty-five patients (83%) died during the course of this study. Nineteen deaths (82%) corresponded to patients with SNM and six deaths (75%) to patients with OCM. The overall survival mean time was 21 months (median 12.5) with a range between 1 and 143 months. The 1, 2, 3, and 5 year survival rate for this study was 53.3%, 40%, 15% and 10%, respectively. The oral cavity was the location for the two patients still alive after 5 years. Although survival time correlated with Stage, particularly Stage 1, this was not statistically significant. Survival time did not correlate with surgery or adjuvant therapy. Statistically significant differences were noted between the pathologic features of OCM and SNM. These significant pathologic differences did not correlate with disease specific survival: OCM and SNM (median survival, 17 months vs. 12 months). Mucosal melanoma of the head and neck is a rare entity. Unfortunately, most patients present with advanced local disease. Local, regional recurrences and distant metastasis still occur despite the implementation of aggressive treatment, including surgery, radiation and adjuvant therapy. Despite significant pathologic differences between SNM and OCM, no survival advantage was seen.
Kotkantie 41, Department of Surgery, Kymenlaakso Central Hospital, Finland. email@example.com.
AIM: To explore whether preoperative chemoradiation therapy improves survival of patients with pancreatic cancer undergoing resectional surgery. METHODS: Forty-seven patients with a malignant pancreatic tumor localized in the head or uncinate process of the pancreas underwent radical pancreatico-duodenectomy. Twenty-two received chemoradiation therapy (gemcitabine and radiation dose 50.4 Gy) before surgery (CRR) and 25 patients underwent surgery only (RO). The study was non-randomised. Patients were identified from a prospective database. RESULTS: The median survival time was 30.2 mo in the CRR group and 35.9 mo in the RO group. No statistically significant differences were found in subclasses according to lymph node involvement, TNM stages, tumor size, or perineural invasion. The one, three and five year survival rates were 81%, 33% and 33%, respectively, in the CRR group and 72%, 47% and 23%, respectively, in the RO group. In ductal adenocarcinoma, the median survival time was 27 mo in the CRR group and 20 mo in the RO group. No statistically significant differences were found in the above subclasses. The one, three and five year survival rates were 79%, 21% and 21%, respectively, in the CRR group and 64%, 50% and 14%, respectively, in the RO group. The overall hospital mortality rate was 2%. The morbidity rate was 45% in the CRR group and 32%(NS) in the RO group. CONCLUSION: Major multicenter randomized studies are needed to conclusively assess the impact of neoadjuvant treatment in the management of pancreatic cancer.
Department of Surgical Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow 226014, India. firstname.lastname@example.org
PURPOSE Patterns of failure following surgical treatment of ampullary cancers indicate that up to 45% of patients develop loco-regional recurrence. The effect of adjuvant chemo-radiotherapy on survival and loco-regional control is not yet established in this malignancy. PATIENTS AND METHODS From January 1989 to December 2000, 113 patients underwent pancreatico-duodenectomy for ampullary cancer. One hundred and four patients who survived the operation were available for analysis to study the effect of adjuvant chemo-radiotherapy on survival and loco-regional control. Forty-nine patients received adjuvant chemo-radiotherapy (median dose 50.4 Gy with concurrent 5-Flurouracil) and long-term outcome in these patients was compared with those 55 who did not receive adjuvant therapy. RESULTS The overall median survival was 30.1 (range 1.6-140.0) months with actuarial 1, 3 and 5-year survival rates of 79, 43 and 33%, respectively. No significant difference in median survival (34.6 vs 24.5 months; P=0.3) and actuarial 5-year survival rates (38 vs 28%) was seen between those who received and those who did not receive adjuvant therapy. Adjuvant chemo-radiotherapy did not influence the survival in high-risk patients (P=0.84), in various T and N stages and had no impact on loco-regional recurrence (P=0.6). CONCLUSIONS Adjuvant chemo-radiotherapy did not improve the long-term survival or decrease recurrence rates in patients with ampullary cancers who had undergone pancreatico-duodenectomy.
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Second Medical University, Shanghai 200011, China. email@example.com
OBJECTIVE To evaluate the clinical outcome of craniofacial resection for advanced malignant tumors in oral and maxillofacial regions. METHODS Forty-six patients who underwent craniofacial resection for malignancies involving the anterior and middle cranial fossa over a 20-year period between June 1978 and December 1997 at our department were evaluated. Twenty patients received radiation therapy and an adjuvant therapy after the operation. Eleven patients received chemotherapy of various types as an adjuvant therapy. RESULTS The 3- and 5-year survival rates were 48.8%(20/41) and 35.1%(13/37), respectively, while the 10-year survival rate was 20%(4/20). CONCLUSIONS Our results revealed good prospects of using craniofacial resection on patients with advanced malignancies in the oral and maxillofacial regions.