High-altitude hypoxia is closely associated with cancer initiation and progression.Hypoxia promotes tumor development through multiple mechanisms including modifying acidic microenvironment,triggering tumor angiogenesis,influencing vasculogenic mimicry,inducing epithelial-mesenchymal transition,remodeling of extracellular matrix,promoting immune escape and adaptive landscapes,maintaining cancer stem cells and inhibiting senescence.Targeting hypoxia may become a novel efficient strategy for cancer therapy.

Tumor related-inflammation is important component of tumor microenvironment. The inflammation status in tumor microenvironment may demolish immunosystem, influence signaling transduction and change the homing of normal stem cell in tumor microenvironment, which probably promote tumor development. The better understanding of molecular pathway of tumor related inflammation would be helpful for identification of novel molecular targets.

Objective To construct a new staging scheme for patients with hepatocellular carcinoma(HCC).Methods A retrospective analysis of HCC cases from 1999 to 2003 was performed.The Cox model was used for multivariate analyses.The final model was derived from 10 randomly-chosen training samples and the prognostic validity of the new staging score was assessed on the corresponding testing samples.Results A simple scoring system was produced,assigning linear scores(0/1/2) to the covariates (TNM,?-fetoprotein,and Child-Pugh).Compared with Okuda stage and CLIP score,the new staging system,structured as a five-category tool,had a greater discriminant ability.Conclusion The new staging system,accounting for both liver function and tumor characteristics,can accurately identify patients with different prognoses,particularly in the advanced phases of HCC,thus representing a useful tool in the treatment of the disease.

Cancer is like a planet , which consists of a heterogeneous mixture of distinct cancer cells . Cancer planet includes four varying levels:niche,surface,middle and core .Cancer architecture based system ther-apies are starting to be exploited for the development of novel strategies to war for cancer .

With the coming era of targeted therapy,novel criteria such as the modified response evalu-ation criteria in solid tumors (RECIST),positron emission tomography response criteria in solid tumors (PETRCIST),Choi criteria and immune-related response criteria have been proposed as standardized methods to assess therapeutic response.Biomarkers and circulating tumor cells may be considered suitable for the evalu-ation of response.These criteria may be useful for the evaluation of therapeutic response to tumors.

Precision chemotherapy is the prospective direction of cancer chemotherapy,which involves the selection of the effective chemotherapy regimens based on the chemotherapy-related genes.Chemotherapyrelated genes include DNA repair genes,drug metabolism enzymes,drug transporters,apoptosis-related genes and cancer-related genes.These genes can predict the response and toxicity of chemotherapy,and determine the clinical outcome.

Rational microenvironment contributes actively to cancer development through multiple mechanisms including triggering genomics instability,providing shield,promoting immune escape,inducing differentiation and permissive nich.Tumorigenesis reversely promotes the form of tumor microenvironment composed of hypoxia,decreasing pH,angiogenesis and nutrition deficiency.Tumor microenvironment not only is the reasons but also results in cancer development and progression.A better understanding of how the tumor environment affects cancer progression would provide the new strategy for cancer therapy.

As semi-autonomous organelles,mitochondria are easily damaged by various factors.Mitochondrial dysfunction such as abnormal oxidative phosphorylation,metabolism alterations,apoptosis prevention,damaged mitophagy,immune escape and deregulated signaling pathway have been hypothesized to be involved in tumorigenesis.Modulated mitochondria may prevent the occurrence of tumors.

In patients with initially diagnosed unresectable cancers,resection of cancer sometimes becomes possible by systemic chemotherapy,and this model of chemotherapy is defined as conversion chemo-therapy. Conversion chemotherapy can improve objective response rate and resection rate,and it has shown an important value in metastatic colorectal cancer,advanced gastric cancer and unresectable hepatocellular carci-noma.

Maintenance therapy is an important strategy for cancer treatment,which mainly include continuation maintenance therapy and switch maintenance therapy,with a classical model of metronomic chemo-therapy.Maintenance therapy can be an effective treatment option for patients with non-small cell lung cancer, breast cancer,colorectal cancer and ovarian cancer.