scholarly journals LDOC1 regulates Wnt5a expression and osteosarcoma cell metastasis and is correlated with the survival of osteosarcoma patients

Tumor Biology ◽  
2017 ◽  
Vol 39 (2) ◽  
pp. 101042831769118 ◽  
Author(s):  
Bi-Cheng Yong ◽  
Jin-Chang Lu ◽  
Xian-Biao Xie ◽  
Qiao Su ◽  
Ping-Xian Tan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Disease Free Survival ◽  
Migration And Invasion ◽  
Polymerase Chain Reaction Primer ◽  
Osteosarcoma Cells ◽  
Chain Reaction ◽  
Free Survival ◽  
Kaplan Meier ◽  
Polymerase Chain ◽  
Disease Free

Osteosarcomas are common bone malignancies in children and adolescents. LDOC1 (leucine zipper, down-regulated in cancer 1), a tumor suppressor, is down-regulated in many cancers. In this study, we investigated the role of LDOC1 in tumor metastasis and its prognostic significance in osteosarcomas. We established osteosarcoma cells stably expressing LDOC1, driven by an HIV-based lentiviral system. We investigated the impact of LDOC1 on migration and invasion abilities in these cells using a transwell assay. LDOC1-associated changes in expression of metastasis-promoting genes were analyzed with a quantitative real-time polymerase chain reaction primer array. A xenograft tumor model (n = 7 mice/group) was used to assess the effect of LDOC1 on osteosarcoma metastasis in vivo. The overall survival and disease-free survival of osteosarcoma patients (n = 74) were analyzed retrospectively based on immunohistochemical analysis of LDOC1 levels in tumors and Kaplan–Meier analysis. LDOC1-expressing osteosarcoma cells displayed decreased migration and invasion in vitro. The quantitative real-time polymerase chain reaction primer array data showed that increased LDOC1 expression up-regulated many metastasis-suppressor genes. In the xenograft model, micro-computed tomography imaging data indicated that increased LDOC1 expression is associated with weaker lung metastasis ability. The Wnt5a signaling pathway promotes osteosarcoma metastasis; LDOC1 expression decreased Wnt5a levels in osteosarcoma cells. Kaplan–Meier analysis showed that higher LDOC1 expression was associated with improved osteosarcoma patient overall survival and disease free survival (p = 0.022). Our data show that LDOC1 is a tumor suppressor in osteosarcoma, and that it regulates metastasis of osteosarcoma cells. Furthermore, LDOC1 might be a valuable prognostic marker in osteosarcomas.

scholarly journals Phase 2 Study of Abbreviated 3 Cycles of Rituximab Plus CHOP (Cyclophosphamide, Adriamycin, Vincristine, and Prednisolone) Immunochemotherapy in Patients with Completely Excised Stage I or II CD20+ Diffuse Large B-Cell Lymphoma (CISL 12-09)

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4193-4193
Author(s):  
Dok Hyun Yoon ◽  
Byeong Seok Sohn ◽  
Jung Yong Hong ◽  
Sung Yong Oh ◽  
Won-Sik Lee ◽  
...  
Keyword(s):  
Overall Survival ◽  
Disease Progression ◽  
Surgical Resection ◽  
Disease Free Survival ◽  
B Cell Lymphoma ◽  
Stage I ◽  
Chop Chemotherapy ◽  
Free Survival ◽  
Kaplan Meier ◽  
Disease Free

Abstract Introduction: Full cycles of R-CHOP chemotherapy or abbreviated chemotherapy followed by radiotherapy are recommended as standard of care for limited stage (LS) diffuse large B-cell lymphoma (DLBCL). There are occasions when lesions are completely excised during the diagnostic surgical resection. In addition, initial surgical resection of the involved area is often performed in the treatment of intestinal lymphomas with LS disease due to obstructive lesions or perforation risk. As to these patients without residual gross lesions, however, the number of cycles of chemotherapy has not so far been questioned and full cycles of chemotherapy are usually performed. Thus, we aimed to investigate the effectiveness of an abbreviated three courses of R-CHOP chemotherapy in patients with completely excised stage I or II CD20+ DLBCL. Methods: This is a multicenter, single arm, phase 2 study designed to evaluate efficacy and safety of 3 cycles of R-CHOP chemotherapy in low risk LS DLBCL. Key inclusion criteria were as follows: pathologically confirmed CD20 positive DLBCL, age >18 years, stage I or II, and complete resection with no residual lesion after surgical resection. Patients with B symptoms, bulky disease, primary breast, testicular or CNS lymphomas were excluded. R-CHOP chemotherapy started within 6 weeks from surgical resection and was repeated every 3 weeks for 3 cycles. Prophylactic G-CSF was not administered. Radiologic tumor assessment was performed at baseline, every 3 months until 2 years, then every 6 months until 5 years after completion of study treatment. The primary endpoint was 2-year disease-free survival (DFS). Secondary endpoints included overall survival and safety. (ClinicalTrials.gov: NCT01279902.) Results: Twenty-three patients were enrolled between Dec 2010 and May 2013. Of these, one was excluded because of ineligibility and the remaining 22 patients were included in the analysis. The median age at diagnosis was 57 years (range, 29-77 years). Fourteen patients had stage 1 disease and the other eight had stage 2. Preoperative LDH level was available in 11 patients and it was elevated in two of them. Thus, preoperative IPI scores could be calculated in those 11 patients; 0 in 8, 1 in one, and 2 in one patients, respectively. Postoperative IPI scores were 0 in 11, 1 in 10 and 2 in one patients. Primary sites included intestine (n=15), cervical lymph nodes (n=4), stomach (n=1), tonsil (n=1) and spleen (n=1). All the 22 patients completed 3 cycles of R-CHOP chemotherapy as planned. With a median follow-up of 39.5 months (95% CI, 29.9-47.1 months), only one patient showed disease progression and died with the estimated 2-year DFS and OS rates of 95.0%. It was the only one patient with IPI of 2 with elevated LDH and age>60 that showed disease progression at 12.7 months. He had a splenic mass and underwent splenectomy followed by 3 cycles of R-CHOP. He underwent one cycle of salvage R-ESHAP chemotherapy but died of rapid disease progression. No grade 3 or 4 non-hematologic toxicities were observed. Neutropenia was the most common grade 3 or 4 hematologic toxicity which was noted in 8 (36.4%) patients. Three patients experienced G3 febrile neutropenia. Conclusions: Three cycles of abbreviated R-CHOP chemoimmunotherapy is an effective and safe therapeutic approach for patients with localized and completely excised DLBCL especially in those with low-risk IPI. Figure 1 Kaplan-Meier curves of (A) disease-free survival and (B) overall survival. (A) (B) Figure 1. Kaplan-Meier curves of (A) disease-free survival and (B) overall survival. / (A). / (B) Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.

Association of mucin production and survival in colon cancer.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 512-512 ◽  
Author(s):  
John Hogan ◽  
Georges Samaha ◽  
John Burke ◽  
David Waldron ◽  
Eoin Condon ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Free Survival ◽  
Mucin Production ◽  
Kaplan Meier ◽  
The Relationship ◽  
Disease Free

512 Background: Debate persists regarding the relationship between mucin production and cancer-related outcome following curative resection for colon cancer. Lack of consensus is due to (amongst other factors) discrepancies in definition, small cohort studies and the integration of both colon and rectal cancers. This study characterizes the relationship between mucin production and cancer-related outcome in an homogenous single-institute based cohort. Methods: A database spanning demographics, clinico-pathologic characteristics and prognostic factors was generated for all patients undergoing curative-intent colonic resection in the interval 2000 to 2010. Patients were categorized simply as mucin producing (i.e. MC) or non-mucin producing adenocarcinoma (NMC). Primary outcomes included overall survival (time to death from any cause) and disease free survival (time to loco-regional and systemic recurrence). Trends were established for MC and NMC using Kaplan-Meier estimates, plotted and compared using log-rank analysis. Findings significant on univariate analysis were incorporated into multivariate analysis. Cox proportional hazards model was employed to determine the associated hazard of both death and disease recurrence in each group. Statistical analysis was performed using R version 2.15. P < 0.05 was considered significant. Results: 77 mucinous carcinomas (MC) and 358 non mucinous carcinomas (NMC) were included. On univariate analysis, MC was associated with improved overall survival (OS) (P=0.007). Both N1 (HR 1.625, P=0.011) and N2 (HR 2.7, P<0.001) status were associated with adverse OS. On multivariate analysis, MC approached but did not reach statistical significance for improved OS (HR 0.543, P=0.061). A comparison of Kaplan-Meier estimates for overall survival in MC and NMC groups indicated that OS was significantly improved in the MC cohort (P=0.011). There was no difference in disease free survival (P=0.224). Systemic recurrence was greater in the NMC group (P=0.042). Conclusions: Mucin production in colonic adenocarcinoma appears associated with improved overall but not disease-free survival. In addition, the absence of mucin was associated with adverse systemic but not local recurrence.

Transoral laser microsurgery outcomes with early glottic cancer: the Dalhousie University experience

2011 ◽  
Vol 125 (5) ◽  
pp. 509-512 ◽  
Author(s):  
S E Lester ◽  
M H Rigby ◽  
S M Taylor
Keyword(s):  
Overall Survival ◽  
Disease Free Survival ◽  
Glottic Cancer ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Free Survival ◽  
Early Glottic Cancer ◽  
Kaplan Meier ◽  
Disease Free

AbstractObjective:To report the results of transoral laser microsurgery for the treatment of early glottic cancer at our institution.Design:Cohort study. Retrospective review of charts of patients diagnosed with tumour stage 1 or 2 (early stage; no nodes or metastases), previously untreated, primary glottic cancer, treated with transoral laser microsurgery at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. The minimum follow-up period was two years.Setting:Tertiary care head and neck cancer centre.Participants:Fifty-three patients treated between January 2002 and November 2007.Outcome measure:Kaplan–Meier survival analysis for disease-free survival, overall survival and laryngectomy-free survival, at five years.Results:The group comprised 46 men and seven women, with a mean age of 66 years (range 30–84 years). Mean follow up was 40 months (range 12–89 months). There were four cases of complications (7.5 per cent). Kaplan–Meier survival analysis revealed a five-year disease-free survival (including salvage) of 96.2 per cent, a five-year overall survival (all causes) of 88.8 per cent and a five-year laryngectomy-free survival of 98.1 per cent.Conclusion:Transoral laser microsurgery is a safe and effective initial treatment for early laryngeal cancer, and has high rates of laryngeal preservation and disease-free survival.

Surgical Resection and Permanent Brachytherapy for Recurrent Atypical and Malignant Meningioma

Neurosurgery ◽  
2004 ◽  
Vol 54 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Marcus L. Ware ◽  
David A. Larson ◽  
Penny K. Sneed ◽  
William W. Wara ◽  
Michael W. McDermott
Keyword(s):  
Overall Survival ◽  
Surgical Resection ◽  
Surgical Intervention ◽  
Radiation Necrosis ◽  
Disease Free Survival ◽  
Atypical Meningioma ◽  
Malignant Meningioma ◽  
Free Survival ◽  
Kaplan Meier ◽  
Disease Free

Abstract OBJECTIVE Recurrent atypical and malignant meningiomas are difficult to treat successfully. Chemotherapy to date has been unsuccessful, and radiosurgery is limited to smaller tumors. Reoperation alone provides limited tumor control and limited prolonged survival. The addition of brachytherapy at the time of operation is an option. Here, we report the results of our series of patients with recurrent malignant meningioma treated with resection and brachytherapy with permanent low-dose 125I. METHODS The charts of patients in our database with recurrent atypical and malignant meningiomas treated by surgical resection and permanent 125I brachytherapy at the University of California, San Francisco, between 1988 and 2002 were selected for this study. Calculations of disease-free survival and overall survival curves were made by the Kaplan-Meier actuarial method. Univariate analysis between Kaplan-Meier curves was based on the log-rank statistic, with a significance level set at a value of P ≤ 0.05. RESULTS Seventeen patients had recurrent malignant meningioma, and four had recurrent atypical meningioma. The median number of sources implanted after surgical resection was 30 (range, 4–112 sources), with a median total activity of 20 mCi (range, 3.3–85.9 mCi). The median time to progression after brachytherapy was 11.6 months for patients with malignant meningioma and 10.4 months for the combined group. There was a trend toward longer disease-free survival time in patients after gross total resection versus subtotal resection and in patients with tumors located at the convexity and parasagittally versus at the cranial base. These differences did not reach statistical significance. The median overall survival after diagnosis was 9.4 years for patients with atypical meningioma, 6.6 years for those with malignant meningioma, and 8.0 years for all patients combined. Survival from the time of resection and implantation of 125I was 1.6 years for patients with atypical meningioma, 2.4 years for patients with malignant meningioma, and 2.4 years for the combined group. Thirty-three percent of patients had complications requiring surgical intervention. Radiation necrosis occurred in 27% of patients; 13% underwent surgery for radiation necrosis. In addition, 27% had a wound breakdown and required surgical intervention. CONCLUSION The options for patients with recurrent atypical or malignant meningiomas are limited. Our results suggest that for tumors not suitable for radiosurgery, resection followed by permanent brachytherapy should be considered as a potential salvage treatment. However, this approach results in a relatively high complication rate in these heavily treated patients and requires meticulous surgical technique and medical therapies to assist with wound healing after surgery.

scholarly journals Faktor yang Berpengaruh Terhadap Disease Free Survival dan Overall Survival pada Pasien Kanker Payudara Usia Muda di Kota Padang Tahun 2008 - 2018

2020 ◽  
Vol 9 (1S) ◽  
Author(s):  
Magdi Ayuza ◽  
Wirsma Arif Harahap ◽  
Rony Rustam ◽  
Richvan Dana Nindrea
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Disease Free Survival ◽  
Rank Test ◽  
Free Survival ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Disease Free ◽  
Data Register

Kanker Payudara (KPD) pada usia muda memiliki keistimewaan karakteristik. Rekurensi KPD dipengaruhi oleh berbagai faktor antara lain faktor klinis, regimen terapi dan biomolekuler dari tumor itu sendiri. Berbagai macam modalitas terapi KPD, namun masih terdapat risiko terjadinya rekurensi terutama pada pasien dewasa muda. Tujuan: Mengetahui faktor-faktor yang mempengaruhi Disease Free Survival (DFS) dan Overall Survival (OS) pada pasien KPD usia muda di Kota Padang. Metode: Penelitian ini menggunakan desain cohort study retrospectif pada pasien KPD usia muda yang telah mendapatkan pengobatan KPD yang memenuhi kriteria inklusi sebanyak 103 sample yang terdapat pada data register KPD PERABOI Padang. Analisis survival menggunakan Kaplan Meier dengan Log Rank Test. Apabila diperoleh nilai p < 0,05, maka terdapat hubungan bermakna. Hasil: Terdapat perbedaan antara setiap faktor klinis, faktor biomolekuler dan faktor terapi dalam hal rata-rata DFS maupun rata-rata OS, namun tidak terdapat pengaruh yang bermakna secara analisis statistik antara faktor terapi (terapi hormon, radioterapi dan terapi target) terhadap DFS dan OS pada pasien kanker payudara usia muda di Kota Padang (p>0,05). Terdapat pengaruh dari pemberian kemoterapi terhadap DFS pada pasien kanker payudara usia muda di Kota Padang (p<0,05). Simpulan: Tidak terdapat hubungan yang bermakna antara faktor klinis dan faktor biomolekuler dengan DFS dan OS, namun terdapat hubungan bermakna antara pemberian kemoterapi dengan DFS dan OS pada penderita KPD usia muda di kota Padang tahun 2008 – 2018.

scholarly journals Analisis Survival Pasien Kanker Payudara Usia Muda di RSUP DR. M. Djamil Padang Tahun 2008-2017

2018 ◽  
Vol 7 ◽  
pp. 25
Author(s):  
M. Al Farisyi ◽  
Daan Khambri
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Free Survival ◽  
Kaplan Meier ◽  
Disease Free

semua wanita yang didiagnosa kanker payudara. KPD usia muda berhubungan dengan progresifitas yang tinggi, kecenderungan untuk rekurensi dan prognosis yang lebih buruk dibandingkan KPD usia tua. Penelitian ini bertujuan untuk menilai outcome dari pasien KPD usia muda yang mendapatkan pengobatan di RSUP Dr. M. Djamil Padang dari tahun 2008-2017. Desain penelitian ini adalah kohort retrospektif dengan analisis data menggunakan Kaplan Meier dengan Log Rank, pada 71 pasien yang telah didiagnosis KPD secara histopatologi dan mendapatkan terapi (bedah, kemoterapi, radioterapi, hormonal terapi ataupun targetting terapi). Hasil penelitian menunjukkan insiden KPD terbanyak pada range usia 35-40 tahun, dengan ukuran tumor T3, diferensiasi derajat sedang, histopatologi tipe duktal karsinoma dengan Triple Negative Breast Cancer (TNBC) sebagai subtipe yang terbanyak. Disease Free Survival (DFS) didapatkan rata-rata 87.48 bulan dan Overall Survival (OS) sebesar 79.13 bulan. Ukuran tumor didapatkan sebagai faktor yang berhubungan terhadap DFS (p = 0.00).

scholarly journals Διερεύνηση της προγνωστικής αξίας του επιπέδου έκφρασης της πρωτεΪνης MCT4 στο στρώμα που περιβάλλει τα καρκινικά κύτταρα αδενοκαρκινωμάτων παχέος εντέρου και ορθοκολικών ηπατικών μεταστάσεων

2016 ◽  
Author(s):  
Χρίστος Πετρίδης
Keyword(s):  
Overall Survival ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Free Survival ◽  
Regression Methods ◽  
Kaplan Meier ◽  
Disease Free

Σκοπός της εργασίας αυτής είναι ο καθορισμός της προγνωστικής αξίας της μεμβρανικής πρωτεΐνης μεταφοράς μονοκαρβοξυλασών (MCT4) σε ασθενείς με καρκίνο παχέος εντέρου και ηπατικές μεταστάσεις (CRLM). Διερευνήσαμε τη συσχέτιση μεταξύ της έκφρασης της MCT4 στους ασθενείς με CRLM και της συνολικής επιβίωσης (overall survival-OS) καθώς επίσης και του διαστήματος ελευθέρου νόσου (Disease Free Survival – DFS). Η μελέτη της έκφρασης της MCT4 έγινε τόσο στα κύτταρα του στρώματος που περιβάλλουν τις ηπατικές μεταστάσεις και ειδικότερα στους ινοβλάστες που σχετίζονται με τον καρκίνο (CAFs) όσο και στα ίδια τα καρκινικά κύτταρα. Ο πληθυσμός της μελέτης αφορούσε ασθενείς με καρκίνο στο παχύ έντερο οι οποίοι είχαν μεταστατική νόσο μόνο στο ήπαρ χωρίς οποιαδήποτε άλλη εξωηπατική εντόπιση.ΜέθοδοςΠρόκειται για μια αναδρομική έρευνα κατά την οποία χρησιμοποιήθηκαν τα κλινικά αρχεία και τα ιστολογικά παρασκευάσματα 107 ασθενών με καρκίνο παχέος εντέρου και ηπατικές μεταστάσεις. Η ανίχνευση και καθορισμός της έκφρασης της MCT4 πραγματοποιήθηκε με τη χρήση ανοσοϊστοχημείας η οποία αξιολογήθηκε με ημιποσοτική μέθοδο. Δημιουργήθηκαν τελικά δύο ομάδες ασθενών προς σύγκριση της συνολικής τους επιβίωσης (OS) και του διαστήματος ελευθέρου νόσου (DFS). Η πρώτη ομάδα περιλάμβανε τους ασθενείς τους οποίους τα ιστολογικά παρασκευάσματα είχαν ασθενή χρώση για την MCT4 (weak MCT4 expression) και η δεύτερη ομάδα περιλάμβανε αυτούς που παρουσίαζαν ισχυρή χρώση για την MCT4 (strong MCT4 expression). Η στατιστική ανάλυση των αποτελεσμάτων για τη συνολική επιβίωση (OS) και το διάστημα ελεύθερο νόσου (DFS) περιλάμβανε τόσο τη μέθοδο Kaplan-Meier όσο και πολυπαραγοντικές μεθόδους ανάλυσης ( Cox-regression methods).ΑποτελέσματαΤα ιστολογικά δείγματα από CLRΜ των 57 ασθενών (53,27%) παρουσίασαν ασθενή χρώση των κυττάρων του στρώματος ως προς την MCT4 σε αντίθεση με τα δείγματα 50 ασθενών (46,73%) τα οποία παρουσίασαν ισχυρή χρώση των κυττάρων του στρώματος για την MCT4. Από την στατιστική ανάλυση που ακολούθησε οι ασθενείς οι οποίοι εμφάνιζαν ισχυρή χρώση για την MCT4 είχαν μειωμένο διάστημα ελεύθερο νόσου - DFS (HR 1.79; 95%CI, 1.12-2.85; P=0,014) καθώς επίσης και μειωμένη συνολική πενταετή επιβίωση - OS (HR 3.81 95%CI, 1.88-7.72; P<0,001) στην μονοπαραγοντική ανάλυση διακύμανσης. Η συσχέτιση αυτή παρέμεινε στατιστικά σημαντική και κατά τη διενέργεια της πολυπαραγοντικής ανάλυσης για το διάστημα ελεύθερο νόσου – DFS και για τη συνολική πενταετή επιβίωση - OS (HR 1.95; 95% CI, 1.19-3.17; P=0.007, και HR 4.38; 95%CI, 2.15-8.92; P<0.001 αντίστοιχα). Το ποσοστό έκφρασης της MCT4 στα καρκινικά κύτταρα δεν συσχετίζεται με το διάστημα ελεύθερο νόσου – DFS και τη συνολική πενταετή επιβίωση - OS στους ασθενείς με CRLM. Το διάστημα ελεύθερο νόσου – DFS και η συνολική πενταετής επιβίωση - OS για τους ασθενείς με ασθενή χρώση στα κύτταρα του στρώματος για την MCT4 ήταν 43% και 78% ενώ τα αντίστοιχα ποσοστά για τους ασθενείς που εμφανίζαν ισχυρή χρώση για την MCT4 ήταν 15% and 37% αντίστοιχα. ΣυμπέρασμαΤα αποτελέσματα της παρούσας μελέτης συνδέουν την ισχυρή έκφραση της MCT4 στα κύτταρα του στρώματος (και ειδικότερα στους ινοβλάστες-CAFs) με χειρότερη συνολική επιβίωση και συχνότερες υποτροπές στους ασθενείς με καρκίνο παχέος εντέρου και ηπατικές μόνο μεταστάσεις. Τα αποτελέσματα αυτά πρέπει να επικυρωθούν και με άλλες μελέτες για να μπορέσει η MCT4 να καθιερωθεί ως προγνωστικός δείκτης στον CRLM και παράλληλα πρέπει να μελετηθεί η ανάπτυξη αναστολέων της MCT4 οι οποίοι θα μπορούσαν να χρησιμοποιηθούν συνεργικά με τα υπάρχοντα χημειοθεραπευτικά σχήματα για μείωση του κυτταρικού πολλαπλασιασμού και του μεταστατικού δυναμικού των καρκινικών κυττάρων. Η στοχοποίηση με μικρά μόρια-αναστολείς του κυτταρικού μεταβολισμού μπορεί να επιφέρει θετικά ευεργετικά αποτελέσματα στους ασθενείς με κακοήθεια.

Uniportal versus multiportal video-assisted thoracoscopic surgery does not compromise the outcome of segmentectomy

2020 ◽  
Author(s):  
Dong Xie ◽  
Junqi Wu ◽  
Xuefei Hu ◽  
Diego Gonzalez-Rivas ◽  
Yunlang She ◽  
...  
Keyword(s):  
Overall Survival ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Disease Free Survival ◽  
Invasive Adenocarcinoma ◽  
Free Survival ◽  
Kaplan Meier ◽  
Propensity Matching ◽  
Disease Free ◽  
Video Assisted Thoracoscopic Surgery

Abstract OBJECTIVES The goal of this study was to compare the feasibility and safety of uniportal thoracoscopic segmentectomy (UTS) with that of multiportal thoracoscopic segmentectomy (MTS). METHODS From January 2014 to December 2015, a total of 1056 patients who underwent thoracoscopic segmentectomy were identified, including 375 and 681 who had simple and complex segmentectomies, respectively. A propensity matched analysis was applied to compare perioperative indicators. Survival outcomes, which included disease-free survival and overall survival, were assessed by Kaplan–Meier estimates and Cox hazards regression analysis. RESULTS Propensity matching generated 454 paired patients for the UTS and MTS cohorts; the perioperative results were comparable. Survival analysis indicated that the surgical approach (UTS versus MTS) was not an independent risk factor in either disease-free survival (P = 0.247) or overall survival (P = 0.870) of patients with invasive adenocarcinoma. A shorter operative time was observed in patients who had a UTS (P &lt; 0.001) or an MTS (P = 0.011) via a simple segmentectomy compared with those who had a complex segmentectomy. Moreover, 147 and 266 corresponding cases were selected to compare the UTS and MTS in the simple and complex segmentectomy groups, respectively. MTS showed slightly longer operative times (119 vs 108 min; P = 0.007) and drainage duration (P = 0.010) in the simple segmentectomy group. In contrast, UTS was associated with statistically longer operative times (141 vs 133 min; P = 0.016) in the complex segmentectomy group. CONCLUSIONS Although minor differences could be found in the simple and complex segmentectomy groups, respectively, these results were clinically irrelevant. Our study supports UTS as a feasible and safe surgical technique.

Comparison of clinical outcomes between enucleation and regular pancreatectomy in patients with non-functional pancreatic neuroendocrine tumors: a retrospective multicenter and propensity score-matched study

2021 ◽  
Author(s):  
Zhen Yang ◽  
Hengjun Gao ◽  
Jun Lu ◽  
Zheyu Niu ◽  
Huaqiang Zhu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Postoperative Complications ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Neuroendocrine Tumors ◽  
Disease Free Survival ◽  
Pancreatic Neuroendocrine Tumors ◽  
Free Survival ◽  
Estimated Blood Loss ◽  
Disease Free

Abstract Objective There are limited data from retrospective studies on whether therapeutic outcomes after regular pancreatectomy are superior to those after enucleation in patients with small, peripheral and well-differentiated non-functional pancreatic neuroendocrine tumors. This study aimed to compare the short- and long-term outcomes of regular pancreatectomy and enucleation in patients with non-functional pancreatic neuroendocrine tumors. Methods Between January 2007 and July 2020, 227 patients with non-functional pancreatic neuroendocrine tumors who underwent either enucleation (n = 89) or regular pancreatectomy (n = 138) were included. Perioperative complications, disease-free survival, and overall survival probabilities were compared. Propensity score matching was performed to balance the baseline differences between the two groups. Results The median follow-up period was 60.76 months in the enucleation group and 43.29 months in the regular pancreatectomy group. In total, 34 paired patients were identified after propensity score matching. The average operative duration in the enucleation group was significantly shorter than that in the regular pancreatectomy group (147.94 ± 42.39 min versus 217.94 ± 74.60 min, P &lt; 0.001), and the estimated blood loss was also significantly lesser (P &lt; 0.001). The matched patients who underwent enucleation displayed a similar overall incidence of postoperative complications (P = 0.765), and a comparable length of hospital stay (11.12 ± 3.90 days versus 9.94 ± 2.62 days, P = 0.084) compared with those who underwent regular pancreatectomy. There were no statistically significant differences between the two groups in disease-free survival and overall survival after propensity score matching. Conclusion Enucleation in patients with non-functional pancreatic neuroendocrine tumors was associated with shorter operative time, lesser intraoperative bleeding, similar overall morbidity of postoperative complications, and comparable 5-year disease-free survival and overall survival when compared with regular pancreatectomy.

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