Lymphatic metastasis is an important prognostic factor for pancreatic cancer.However,lymphatic metastatic status (N0 or N1) can not reflect the degree of lymphatic metastasis.Lymph node ratio,which is defined as the number of positive lymph nodes divided by total examined lymph nodes,can reflect the degree of lymph metastatic metastasis and give consideration to examined lymph nodes.Lymph node ratio is superior to lymph metastatic status in staging,guiding treatment,and predicting prognosis.However,currently,lymph node ratio cannot replace lymph metastatic status for the undetermined minimum number of examined lymph nodes and cut-off value.Further evidence is needed to prove its clinical value.

Purpose:Despite the declining trend of stomach cancer incidence, it is still the second important cancer in China and ranks first in Yangzhong City. We examined the role of green tea consumption on stomach cancer and chronic gastritis risks by case control study. Interaction between green tea drinking and potential risk factors of stomach cancer and chronic gastrotitis were also explored. Methods:A population based case control study was conducted in Yangzhong, China, with 143 stomach cancer patients, 166 chronic gastitis patients and 433 healthy controls. Epidemiological data were collected by standard questionnaire, and blood samples were obtained for measurement of Helicobacter pylori infection. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models. Results:Inverse association was observed between green tea drinking and stomach cancer and chronic gastritis risks. After adjusting for potential confounding factors, ORs of green tea drinking were 0.46 (95%CI: 0.22—0.96) and 0,46 (95%CI: 0.27—0.77) for stomach cancer and chronic gastritis, respectively. The less ORs of stomach cancer and chronic gastritis, the more frequent the green tea drinking ( P for trend

Objective To study the role of preoperative CA19-9 level in predicting resectability of pancreatic cancer.Methods Preoperative CA19-9 levels were determined by radioimmunoassay.The receiver operating characteristic curve was used to determine the cut-off point.The clinical value of the level of CA19-9 as a predictive marker of resectability was evaluated by the area under curve.Results The preoperative CA19-9 levels in the resectahle group was (313.6±515.5) kU/L,which was significantly lower than (852.1± 865.1)kU/L in the unresectable group (P＜0.001).The cut-off point of CA19-9 for predicting pancreatic cancer resectability was 312.1 kU/L,which had a sensitivity of 56.6％ and a specificity of 73.3％.The area under curve was 0.67.Conclusions The preoperative CA19-9 level may be used to predict resectability of pancreatic cancer.

Pancreatic neuroendocrine tumor is a common pancreatic tumor with high heterogeneity and multiple management modalities. A standard and practical staging system for pancreatic neuroendocrine tumors will be beneficial to clinical management and research. At present, there are two staging systems (ENETS and AJCC). Both of them have shortcomings which limit their clinical application. In addition, the coexistence of two staging systems is confusing to clinicians. We proposed a modified ENETS staging system by keeping the ENETS TNM definition and adopting the AJCC staging definition. The modified staging system can successfully distinguish patients with different prognosis and is helpful in establishing clinical standard. This study has been published in Journal of Clinical Oncology (JCO) and was selected as 2017 Best of JCO: Gastrointestinal edition. This paper was aimed to interpret the modified staging system in clinical practice.

Lymph metastasis has great impact on the prognosis of pancreatic cancer patients, which can relfect the biological and invasive potential of pancreatic cancer. However, currently, there is no standard in the clinical management of the lymph metastasis in pancreatic cancer. In this report, we will discuss and summarize the followings:lymph metastatic rate and its impact on prognosis, the rule of lymph metastasis, sentinel lymph node, intra-operative lymph nodes mapping, TNM staging, regional lymph nodes resection, number of lymph nodes examined, lymph node ratio, guiding adjuvant treatments, lymphatic targeted therapy.

Background and purpose:Ultrasound is a regular screening method of solid pseudopapillary tumor of the pancreas (SPTP). This study was to summarize the diagnostic value of ultrasound to SPTP.Methods:Clinical and ultrasound data of 62 SPTP cases in Fudan University Shanghai Cancer Center were retrospectively collected and analyzed.Results:Five cases of SPTP were undetected by ultrasound in the group. The features of ultrasound including: large mass located at the body and tail of the pancreas, clear boundary and regular shape, low ultrasound with uneven signal, or low signal mixed with no signal. A few cases have calciifcation and blood signal. Most of the cases presented no dilation of main pancreatic duct and bile duct and regional lymph nodes enlargement. Conclusion:Ultrasound can be used to detect SPTP which has special ultrasound signal features.

OBJECTIVETo investigate the treatment outcome of loco-regionally advanced squamous cell carcinoma of the head and neck (LA-SCCHN) after been treated with multi-modality approach since 2005 in our hospital and to explore the prognostic factors for treatment outcomes.

METHODSClinical data of 125 postoperative LA-SCCHN patients treated in our department with radiotherapy/chemoradiotherapy from May 2005 to December 2011 were collected and reviewed in this study. The radiotherapy technique was intensity-modulated radiotherapy (IMRT) (93.6%) and a minority of patients received 3D-conformal radiotherapy (3D-CRT).

RESULTSUp to January 6th, 2013, 124 patients were followed up with a median follow-up duration of 25 months. The 3-year overall survival (OS), disease-free survival (DFS), loco-regional control (LRC), distant metastasis-free survival (DMFS) were 69.7%, 56.1%, 80.8%, and 73.1%, respectively. A total of 37 patients died during the follow-up period. Among the 43 patients presented with treatment failure, 13 patients had loco-regional relapse, 20 patients had distant metastasis and 10 patients presented with both loco-regional and distant relapses. Distant metastasis accounted for the predominant cause of death. Lung and mediastinal lymph nodes are the most common sites involved by distant metastasis.Univariate analysis indicated that patients who underwent non-radical surgery, with larger size of invaded lymph nodes, higher N stage (N2b and above) and vascular tumor embolism had a lower OS (P = 0.001, 0.000, 0.032, 0.007, respectively). Patients who underwent neck dissection only, or those with higher N stage (N2b and above) or higher TNM stage or vascular tumor thrombi had higher distant metastasis rates (P = 0.017, 0.002, 0.008, 0.001, respectively). The multivariate analysis showed that non-radical surgery was an independent prognostic factor for OS (P = 0.001), larger size of invaded lymph nodes was an independent prognostic factor for poorer LRC (P = 0.001); higher N stage (N2b and above) or T4 stage and vascular tumor thrombi were independent prognostic factors for poorer distant metastasis-free survival (P = 0.035, 0.008 and 0.050, respectively).

CONCLUSIONSOur results indicate that multi-modality treatment for LA-SCCHN has achieved better outcome than before. Distant metastasis has become the predominant pattern of failure as well as the primary cause of death instead of loco-regional relapse as a result of improved local control modality. More efforts should be made to decrease the rate of distant metastasis in the future.

Adult ; Aged ; Antibodies, Monoclonal, Humanized ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Squamous Cell ; pathology ; secondary ; therapy ; Cetuximab ; Cisplatin ; therapeutic use ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Fluorouracil ; therapeutic use ; Follow-Up Studies ; Head and Neck Neoplasms ; pathology ; secondary ; therapy ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neoplastic Cells, Circulating ; Radiotherapy, Conformal ; Radiotherapy, Intensity-Modulated ; Survival Rate ; Taxoids ; therapeutic use