简介：Objective:Cancerisoneofthemostcommondiagnosesinelderlypatients.Ofalltypesofabdominalcancer,colorectalcancer(CRC)isundoubtedlythemostfrequent.Medianageatdiagnosisisapproximately70yearsoldworldwide.Duetothemultiplecomorbiditiesaffectingelderlypeople,frailtyevaluationisveryimportantinordertoavoidover-orundertreatment.Thispilotstudywasdesignedtoinvestigatethevariablescapableofpredictingthelong-termriskofmortalityandlivingsituationaftersurgeryforCRC.Methods:Patientswith70yearsoldandolderundergoingelectivesurgeryforCRCwereprospectivelyenrolledinthestudy.Thepatientswerepreoperativelyscreenedusing11internationally-validated-frailty-assessmenttests.Theendpointsofthestudywerelong-termmortalityandlivingsituation.ThedatawereanalyzedusingunivariateCoxproportional-hazardregressionanalysistoverifythepredictivevalueofscoreindicesinordertoidentifypossibleriskfactors.Results:Forty-sixpatientswerestudied.Themedianfollow-uptimeaftersurgerywas4.6years(range,2.9-5.7years)andnopatientswerelosttofollow-up.Theoverallmortalityratewas39%.Fourofthepatientswhosurvived(4/28,14%)losttheirfunctionalautonomy.ThepreoperativeimpairedTimedUpandGo(TUG),EasternCooperativeGroupPerformanceStatus(ECOGPS),InstrumentalActivitiesofDailyLiving(IADLs),VulnerableEldersSurvey(VES-13)scoringsystemsweresignificantlyassociatedwithincreasedlongtermmortalityrisk.Conclusion:Simplifiedfrailty-assessingtoolsshouldberoutinelyusedinelderlycancerpatientsbeforetreatmentinordertostratifypatientrisk.TheTUG,ECOG-PS,IADLsandVES-13scoringsystemsarepotentiallyabletopredictlong-termmortalityanddisability.Additionalstudieswillbeneededtoconfirmthepreliminarydatainordertoimprovemanagementstrategiesforoncogeriatricsurgicalpatients.

简介：Objective:Toassesstheresponserateofpatientswithrectaladenocarcinomatoneoadjuvanttherapyandtoidentifythepredictorsofhistologicalregressionafterneoadjuvantradiotherapy(RT)orconcurrentchemoradiotherapy(CCRT).Methods:Thisstudyrecruited64patients.Thepatientshadresectablecancerofthelowerandthemiddlerectum(T3/T4and/orN+)withoutdistantmetastasisandreceivedneoadjuvantRTorCCRTfollowedbyradicalsurgerywithtotalmesorectalexcision(TME)betweenJanuary2006andDecember2011.Thepatientswereclassifiedintonon-response(NR),partialresponse(PR),andpathologiccompleteresponse(pCR)basedontheDworaktumorregressiongradingsystem.Results:Themedianageofpatientswas57years(rangingfrom22to85).Atotalof24patientsweretreatedwithneoadjuvantCCRT,whereas40patientsweretreatedwithRTalone.Abdominoperinealresection(APR)wasperformedon29patients(45%).AnteriorresectionwithTMEwasperformedon34patients(53%).Onepatienthadlocalresection.Histologically,12(19%),24(73%),and28(44%)patientsexhibitedpCR,PR,andNR,respectively.Univariateanalysisrevealedthatthepredictorsoftumorregressionwereasfollows:theabsenceoflymphnodeinvolvementfrominitialimaging(cN0)(P=0.021);normalinitialcarcinoembryonicantigen(CEA)level(P=0.01);hemoglobinlevel≥12g/dl(P=0.009);CCRT(P=0.021);andtumordownstaginginimaging(P=0.001).MultivariateanalysisshowedthatthemainpredictorsofpCRwereCTcombinedwithneoadjuvantRT,cN0stage,andtumorregressiononimaging.Conclusions:IdentifyingthepredictorsofpCRfollowingneoadjuvanttherapyaidstheselectionofresponsivepatientsfornonaggressivesurgicaltreatmentandpossiblesurveillance.

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简介：Objective:Toanalyzetheclinicopathologiccharacteristicsandprognosticfactorsofsmallgastrointestinalstromaltumor(GIST)ofthestomach.Methods:Atotalof31smallgastricGISTpatients,including10malesand21females,withamedianageof58years(37-81years),whounderwentsurgeryatanytimefrom1999to2012wereincludedinthisstudy.Theclinicalrecordsofthepatientswereanalyzedretrospectively.Results:Abdominaldiscomfortandpain(10cases,32.3%,respectively)werethetwomostcommoncomplaintsamongthepatients.Allpatientsreceivedsurgery,11receivedgastricwedgeresection,11receivedsubtotalgastrectomy,5receivedlaparoscopicgastricwedgeresection,and4receivedendoscopicsubmucosaldissection.Nosevereadversecomplicationwasobserved.Atotalof29patients(93.5%)werefollowedup.Duringthefollow-up,2patientswerefoundtoexhibittumorrecurrence,and1patienthadlivermetastases.Onepatientdiedoftumorprogression,whileanotherdiedofanothermalignanttumor.Medianprogressionfreesurvival(PFS)timewas120.3months,andmedianoverallsurvival(OS)timewas130.4months.Conclusion:SmallgastricGISThasbetterprognosis.Surgeryisthebestchoicefortherapy.Micro-invasiveproceduresaresafeandeffectiveforelectivepatients.Tumornecrosis,tumorbleeding,andmuscleinvasionarepotentialprognosticfactorsofsmallgastricGIST.

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简介：Objective:ToevaluatethefeasibilityofDNAimagecytometry(DNA-ICM)asaprimaryscreeningmethodforesophagealsquamouscellcancer(ESCC).Methods:Atotalof5,382localresidentsaged40–69yearsfromthreehigh-riskareasinChina(LinzhouinHenanprovince,FeichenginShandongprovinceandCixianinHebeiprovince)from2008to2011wererecruitedinthispopulation-basedscreeningstudy.And2,526subjectsdeclinedtoreceiveendoscopicbiopsyexaminationwithLugol'siodinestaining,while9and815subjectswereexcludedfromliquid-basedcytologyandDNA-ICMtestrespectivelyduetoslidequality.Finally,2,856,5,373and4,567subjectswereenrolledintheanalysisforendoscopicbiopsyexamination,liquid-basedcytologyandDNA-ICMtest,respectively.Sensitivity(SE),specificity(SP),negativepredictivevalues(NPV)andpositivepredictivevalues(PPV)aswellastheir95%confidenceintervals(95%CI)forDNA-ICM,liquid-basedcytologyandthecombinationofthetwomethodswerecalculated.Receiveroperatingcharacteristic(ROC)curveswereappliedtodeterminethecutoffpointofDNA-ICMforesophagealcancer.Results:DNA-ICMresultsweresignificantlycorrelativewithesophagealcancerandprecancerlesions(χ~2=18.016,P<0.001).Thecutoffpointswere5,802,5,803and8,002basedondissimilarpathologicaltypesoflowgradeintraepithelialneoplasia(LGIN),highgradeintraepithelialneoplasia(HGIN),andESCC,respectively,and5,803waschoseninthisstudyconsideringtheSEandSP.TheSE,SP,PPV,NPVofDNA-ICMtest(cutoffpoint5,803)combinedwithliquid-basedcytology[thresholdatypicalsquamouscellsofundeterminedsignificance(ASCUS)]wereseparately72.1%(95%CI:70.3%-73.9%),43.3%(95%CI:41.3%-45.3%),22.8%(95%CI:21.1%-24.5%)and87.0%(95%CI:85.7%-88.3%)forLGIN,85.7%(95%CI:84.3%-87.1%),41.3%(95%CI:39.3%-43.3%),4.6%(95%CI:3.8%-5.4%)and98.9%(95%CI:98.5%-99.3%)forHGIN,and96.0%(95%CI:95.2%-96.8%),40.8%(95%CI:38.8%-42.8%),1.7%(95%CI:1.2%-2.2%)and99.9%