We have clinically observed 39 patients with abdominal tumors who were admitted in Severance Hospital during the past 10 years from April 1960 to March 1970. Unfortunately follow-up study couldn't be made. The following results were obtained. 1) Of the total number observed, 25 patients were male and 14 patients female. 2) The majority of the patients, 34 (87%) were under 6 years of age and 20 (51%) were between 1 to 3 years of age. The youngest patient was a 3-month-old female with Wilms' tumor. 3) In our series, Wilms' tumor (15 cases, 38.5%) was the most common and neuroblastoma (8 cases) was next most common tumor in the abdominal cavity. In addition we found another 4 cases of neuroblastoma in other sites. We observed hepatoma (8cases), ovarian tumor (3cases), lymphosarcoma (2cases), mesenteric cyst (one case) and adenoma of the left adrenal gland (one case) in that order of frequency. 4) In 15patients with Wilms' tumor, hypertension was observed in 8 patients and hematuria in 4 patients. Compared with Wilms' tumor, no hematuria was noted in the cases with neuroblastoma and hypertension occurred in 3 of these. 5) On abdominal X-ray, calcification was present in 4 cases with neuroblastoma (50%) and was present in only one of 15 patients with Wilms' tumor. 6) Comparing the sites of metastasis between Wilms' tumor and neuroblastoma, 4 of 15 patients with Wilms' tumor had lung metastasis and 4 of 8 patients of neuroblastoma had bony metastasis. Liver metastasis was found at autopsy in one case of neuroblastoma. 7) Three cases of hepatoblastoma were under 2 years of age and three cases of hepatocarcinoma were over 12 years of age. 8) Three cases of ovarian tumor were benign cystic teratoma. Tortion of the ovarian pedicle occurred in one of 3 patients with severe low abdominal pain. All patients were discharged in good condition after salphingo-oophorectomy. 9) One case of lymphosarcoma of the ileum was associated with intussusception. 10) A one year o1d female with adenoma of the left adrenal gland had typical Cushing's syndrome.
Abdominal Neoplasms/epidemiology* ; Adolescent ; Carcinoma, Hepatocellular/epidemiology ; Child ; Child, Preschool ; Female ; Human ; Infant ; Korea ; Liver Neoplasms ; Lymphoma, Non-Hodgkin/epidemiology ; Male ; Mesenteric Cyst/epidemiology ; Nephroblastoma/epidemiology ; Neuroblastoma/epidemiology ; Ovarian Neoplasms/epidemiology

OBJECTIVETo investigate the association between anthropometry and risk of breast cancer among pre-and post-menopausal women in urban Shanghai.

METHODSA total of 73 461 female residents aged 40 to 70 years in urban Shanghai were recruited in a prospective cohort study (the Shanghai women's health study) during 1997 through 2000, and were actively followed up biennially. During mean follow-up period of 5.66 years, 432 incident cases of breast cancer were identified in the cohort. Cox regression model was used to estimate the adjusted relative risks (RRs) and 95% confidence intervals (CIs).

RESULTSAfter adjustment for some potential confounding factors, baseline weight, body mass index(BMI), waist-to-hip ratio(WHR) and weight gain since age 20 were positively associated with the increased risk of breast cancer among postmenopausal women. The positive association between height and breast cancer was found among premenopausal women. Among them, those with height taller than 161 cm at age 20 experienced 1.84 fold increased risk (95% CI: 1.30-2.61) of breast cancer compared to their counterpart with height shorter than 157.1 cm. Women who were either much heavier or lighter than average at age 20 were at reduced risk. Further analyses mutually adjusted for BMI and WHR did not substantially alter the positive association for both BMI and WHR. After further adjustment for BMI, weight gain since age 20 was significantly associated to an increased risk for postmenopausal breast cancer (RR = 1.61, 95% CI: 1.09-2.37).

CONCLUSIONSWeight gain and central obesity seemed to be strong predictors for the risk of breast cancer among postmenopausal women. Controlling weight and decreasing fat around waist were effective means to prevent postmenopausal breast cancer and height might serve as a risk factor for premenopausal breast cancer.

Adult ; Aged ; Anthropometry ; Breast Neoplasms ; epidemiology ; China ; epidemiology ; Female ; Humans ; Middle Aged ; Obesity, Abdominal ; Postmenopause ; Risk ; Urban Population ; Weight Gain

Objective: To investigate the effect of visceral fat area (VFA) on the surgical efficacy and early postoperative complications of radical gastrectomy for gastric cancer. Methods: A retrospective cohort study method was used. Clinicopathological data and preoperative imaging data of 195 patients who underwent D2 radical gastric cancer surgery at the First Affiliated Hospital of Xi'an Jiaotong University from January 2014 to December 2017 were analyzed retrospectively. Inclusion criteria: (1) complete clinicopathological and imaging data; (2) malignant gastric tumor diagnosed by preoperative pathology, and gastric cancer confirmed by postoperative pathology; (3) no preoperative complications such as bleeding, obstruction or perforation, and no distant metastasis. Those who had a history of abdominal surgery, concurrent malignant tumors, poor basic conditions, emergency surgery, palliative resection, and preoperative neoadjuvant therapy were excluded. The VFA was calculated by software and VFA ≥ 100 cm² was defined as visceral obesity according to the Japan Obesity Association criteria . The patients were divided into high VFA (VFA-H, VFA≥100 cm², n=96) group and low VFA (VFA-L, VFA<100 cm², n=99) group . The clinicopathological characteristics, surgical outcomes and early postoperative complications were compared between the two groups. Univariate and multivariate Logistic regression models were used to analyze the risk factors of early complications. Receiver operating characteristic (ROC) curve was used to analyze predictive values of VFA for early complications. Pearson's χ² test was used to analyze the correlation between BMI and VFA. Results: There were no significant differences in terms of gender, age, American Society of Anesthesiologists physical status classification, preoperative comorbidities, preoperative anemia, tumor TNM staging, N staging, T staging and tumor differentiation, surgical method, extent of resection, and tumor location between the VFA-L group and the VFA-H group (all P>0.05). However, patients in the VFA-H group had higher BMI, larger tumor, lower rate of hypoalbuminemia and greater subcutaneous fat area (SFA) (all P<0.05). The VFA-H group presented significantly longer operation time and significantly less number of harvested lymph nodes as compared to the VFA-L group (both P<0.05). However, there were no significant differences in intraoperative blood loss, conversion to laparotomy and postoperative hospital stay (all P>0.05). Complications of Clavien-Dindo grade II and above within 30 days after operation were mainly anastomosis-related complications (leakage, bleeding, infection and stricture), intestinal obstruction and incision infection. The VFA-H group had a higher morbidity of early complications compared to the VFA-L group [24.0% (23/96) vs 10.1% (10/99), χ²=6.657, P=0.010], and the rates of anastomotic complications and incision infection were also higher in the VFA group [10.4% (10/96) vs. 3.0% (3/99), χ²=4.274, P=0.039; 7.3% (7/96) vs. 1.0% (1/99), P=0.033]. Multivariate logistic analysis showed that high BMI (OR=3.688, 95%CI: 1.685-8.072, P=0.001) and high VFA (OR=2.526, 95%CI: 1.148-5.559,P=0.021) were independent risk factors for early complications. The area under the ROC curve (AUC) of VFA for predicting early complications was 0.645, which was higher than that of body weight (0.591), BMI (0.624) and SFA (0.626). Correlation analysis indicated that there was a significantly positive correlation between BMI and VFA (r=0.640, P<0.001). Conclusion: VFA ≥ 100 cm² is an independent risk factor for early complications after radical gastrectomy for gastric cancer.It can better predict the occurrence of above early postoperative complications.
Gastrectomy/methods* ; Humans ; Laparoscopy/methods* ; Lipids ; Obesity/surgery* ; Obesity, Abdominal/surgery* ; Postoperative Complications/epidemiology* ; Retrospective Studies ; Stomach Neoplasms/pathology*

BACKGROUND/AIMS: Abdominal obesity and hyperinsulinemia or insulin resistance are of interest in connection with colon carcinogenesis. We conducted a prospective case controlled study for the evaluation of relationship between abdominal obesity, insulin resistance, and colorectal adenoma. METHODS: Fifty patients with colorectal adenoma and fifty healthy subjects were included in this study. Total colonoscopic examinations were performed in all the subjects. Fasting blood sugar (FBS), insulin, homeostasis model assessment (HOMA-IR), triglyceride (TG), cholesterol (CROL), BMI (body mass index), WHR (waist hip ratio), percent body fat (PBF) and obesity degree (OD) were measured. HOMA-IR was considered to represent insulin resistance. Diabetic patients were excluded from this study. RESULTS: There were no differences in sex, serum insulin, FBS, HOMA-IR, TG, CROL between adenoma and control group. Subjects with high BMI, WHR, percent body fat, and obesity were more likely to have colonic adenoma. Multiple logistic regression analysis after adjusting confounding factors, had revealed that WHR was the most important independent risk factor for colon adenoma. CONCLUSIONS: Abdominal obesity was most closely related to colonic adenoma. However, insulin resistance was not related to colonic adenoma. A larger case controlled study is needed.
*Abdominal Fat ; Adenoma/diagnosis/epidemiology/*etiology ; Aged ; Body Fat Distribution ; Body Mass Index ; Colonic Neoplasms/diagnosis/epidemiology/*etiology ; Colonoscopy ; Female ; Humans ; *Insulin Resistance ; Male ; Middle Aged ; Obesity/*complications/epidemiology/pathology ; Risk Factors ; Waist-Hip Ratio

OBJECTIVE: In this study we utilized the Surveillance, Epidemiology and End-Results (SEER) registry to identify risk factors for lymphatic spread and determine the incidence of pelvic and para-aortic lymph node metastases in patients with uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC) who underwent complete surgical staging and lymph node dissection. METHODS: Nine hundred seventy-two eligible patients diagnosed between 1998 to 2009 with International Federation of Gynecology and Obstetrics (FIGO) 1988 stage IA-IVA UPSC (n=685) or UCCC (n=287) were identified for analysis. Binomial logistic regression was used to determine risk factors for lymph node metastasis, with the incidence of pelvic and para-aortic lymph node metastases reported for each FIGO primary tumor stage. The Cox proportional hazards regression model was used to determine factors associated with overall survival. RESULTS: FIGO primary tumor stage was the only independent risk factor for lymph node metastasis (p<0.01). The incidence of pelvis-only and para-aortic lymph node involvement according to the FIGO primary tumor stage were as follows: IA (2.3%/3.8%), IB (7.5%/5.2%), IC (22.5%/16.9%), IIA (20.8%/13.2%), IIB (25.7%/14.9%), and III/IV (25.7%/24.3%). Prognostic factors for overall survival included lymph node involvement (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.09 to 1.85; p<0.01), patient age >60 years (HR, 1.70; 95% CI, 1.21 to 2.41; p<0.01), and advanced FIGO primary tumor stage (p<0.01). Tumor grade, histologic subtype, and patient race did not predict for either lymph node metastasis or overall survival. CONCLUSION: There is a high incidence of both pelvic and para-aortic lymph node metastases for FIGO stages IC and above uterine papillary serous and clear cell carcinomas, suggesting a potential role for lymph node-directed therapy for these patients.
Adenocarcinoma, Clear Cell/epidemiology/pathology/*secondary/surgery ; Adult ; Aged ; Aged, 80 and over ; Aorta, Abdominal ; Cystadenocarcinoma, Papillary/epidemiology/pathology/*secondary/surgery ; Cystadenocarcinoma, Serous/epidemiology/pathology/*secondary/surgery ; Female ; Humans ; Incidence ; Kaplan-Meier Estimate ; Lymph Node Excision ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Pelvis ; SEER Program ; United States/epidemiology ; Uterine Neoplasms/*epidemiology/pathology/surgery

PURPOSE: Intraabdominal abscess is one of the most common reasons for re-hospitalization after gastrectomy. This study aimed to develop a model for estimating the probability of intraabdominal abscesses that can be used during the postoperative period. MATERIALS AND METHODS: We retrospectively reviewed the clinicopathological data of 1,564 patients who underwent gastrectomy for gastric cancer between 2010 and 2012. Twenty-six related markers were analyzed, and multivariate logistic regression analysis was used to develop the probability estimation model for intraabdominal abscess. Internal validation using a bootstrap approach was employed to correct for bias, and the model was then validated using an independent dataset comprising of patients who underwent gastrectomy between January 2008 and March 2010. Discrimination and calibration abilities were checked in both datasets. RESULTS: The incidence of intraabdominal abscess in the development set was 7.80% (122/1,564). The surgical approach, operating time, pathologic N classification, body temperature, white blood cell count, C-reactive protein level, glucose level, and change in the hemoglobin level were significant predictors of intraabdominal abscess in the multivariate analysis. The probability estimation model that was developed on the basis of these results showed good discrimination and calibration abilities (concordance index=0.828, Hosmer-Lemeshow chi-statistic P=0.274). Finally, we combined both datasets to produce a nomogram that estimates the probability of intraabdominal abscess. CONCLUSIONS: This nomogram can be useful for identifying patients at a high risk of intraabdominal abscess. Patients at a high risk may benefit from further evaluation or treatment before discharge.
Abdominal Abscess ; Abscess* ; Bias (Epidemiology) ; Body Temperature ; C-Reactive Protein ; Calibration ; Classification ; Dataset ; Discrimination (Psychology) ; Gastrectomy* ; Glucose ; Humans ; Incidence ; Leukocyte Count ; Logistic Models ; Multivariate Analysis ; Nomograms* ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms*