BACKGROUND AND OBJECTIVEExpression of Skp2 was related with the prognosis of several tumors. However, there was no intensive study on the relationship between Skp2 and extranodal NK/T cell lymphoma. This study was to explore the role of Skp2 in extranodal NK/T cell lymphoma.

METHODSThe clinicopathological data of 39 patients with extranodal NK/T cell lymphoma were analyzed. The expression of Skp2 was examined by immunohistochemistry on formalin fixed, paraffin embedded tissue sections.

RESULTSAmong the patients with high expression of Skp2, complete remission (CR) rate was only 14.3% (2/14). However, CR rate among the patients with low expression of Skp2 was 68.0% (17/25). Significant difference was shown between these two groups (P < 0.001). In the group of low expression, the median overall survival (OS) was 85.59 months (95% CI: 35.83 135.34 months), the 1 and 2 year OS rates were 81% and 71%, respectively. However, in the group of high expression, the median OS was only 9.73 months (95% CI: 2.05-17.40 months), the 1 and 2 year OS rates were 42% and 14%, respectively. There was statistical difference between these two groups (P < 0.001). Multivariate analysis showed that Skp2 expression (P <0.001), LDH (P = 0.026) and ECOG PS (P = 0.003) were dependent prognostic factors of extranodal NK/T cell lymphoma.

CONCLUSIONHigh expression of Skp2 is an independent unfavorite adverse prognostic factor of extranodal NK/T cell lymphoma.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; L-Lactate Dehydrogenase ; blood ; Lymphoma, Extranodal NK-T-Cell ; drug therapy ; metabolism ; pathology ; radiotherapy ; Male ; Middle Aged ; Neoplasm Staging ; Remission Induction ; S-Phase Kinase-Associated Proteins ; metabolism ; Survival Rate ; Young Adult

BACKGROUND AND OBJECTIVEAnemia can not only reduce the quality of life of patients with cancer, but also affect their survival. This study was to investigate the prognostic value of hemoglobin (Hb) level in patients with nasopharyngeal carcinoma (NPC) treated with radiotherapy.

METHODSClinical data of 520 NPC patients received definitive radiotherapy between 2000 and 2002 at Sun Yat sen University Cancer Center were analyzed. Patients were stratified into normal Hb level and anemia groups according to their Hb levels before, during, and after radiation. Anemia was defined according to World Health Organization criteria as Hb level < 130 g/L in men and < 120 g/L in women. Hb continuous decrease group and non decrease group were defined according to Hb changes in the patients during radiotherapy. Loco regional recurrence free survival (LRFS) and overall survival (OS) rates were estimated using the Kaplan Meier method. Multivariate analysis was performed using the Cox model to analyze the prognostic factors.

RESULTSBefore radiation, the 5 year LRFS rates were 60.9% in anemia group and 63.9% in normal Hb level group (P = 0.337); the 5 year OS rates were 65.2% and 71.0%, respectively (P = 0.299). During radiation, the 5 year LRFS rates were 56.7% in anemia group and 67.9% in normal Hb level group (P = 0.013); the 5 year OS rates were 61.0% and 75.9%, respectively (P = 0.001). After radiation, the 5 year LRFS rates were 59.6% in anemia group and 64.9% in normal Hb level group (P = 0.169); the 5 year OS rates were 65.0% and 71.9%, respectively (P = 0.090). The 5 year LRFS and OS rates were significantly lower in Hb continuous decrease group than in Hb non decrease group (59.1% vs. 69.3%, P = 0.032; 66.2% vs. 76.4%, P=0.011). Multivariate analysis showed that the continuous decrease of Hb was an independent prognostic factor for OS.

CONCLUSIONThe change in Hb level during radiotherapy is an important prognostic factor affecting the OS of NPC patients.

Adolescent ; Adult ; Age Factors ; Aged ; Anemia ; blood ; etiology ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma ; Cisplatin ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Hemoglobins ; metabolism ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; drug therapy ; radiotherapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Particle Accelerators ; Proportional Hazards Models ; Radiotherapy, High-Energy ; adverse effects ; Survival Rate ; Young Adult

BACKGROUND AND OBJECTIVEThe tonsils are the most commonly involved primary part of non Hodgkin's lymphoma (NHL) of the head and neck, which usually happens in the Waldeyer's ring. Our study describes the features of computed tomography on enlarged tonsils as a first symptom of NHL and the characteristics of the involved cervical lymph nodes.

METHODSA retrospective review was performed on 130 patients with primary extranodal lymphomas of the head and neck over 16 years. Of them 22 untreated patients showed tonsil lesions as a first symptom.

RESULTSBilateral enlarged tonsils were involved in 13 patients, and unilateral lesions were in 9 patients. The lesions in 20 patients appeared mass like, while 2 patients had diffuse thickening. There were 8 patients with simultaneous invasion of the nasopharynx, soft palate, and epiglottis. Of the 19 patients that underwent enhanced CT scans, 15 patients demonstrated slight homogeneous enhancement, 4 with crannied or a patch of low density, and 1 with ring like enhancement. All 22 patients appeared to have cervical lymph nodes involvement. The upper groups of cervical lymph nodes were involved bilaterally in 13 patients, unilaterally in 9 patients. The middle groups were involved bilaterally in 7 patients, unilaterally in 10 patients. The lower groups were involved bilaterally in 2 patients, and unilaterally in 5 patients. After contrast administration, lymph nodes showed homogeneous density and slight enhancement in 11 patients, heterogeneous enhancement with necrosis and cystic changes in 6 patients, and ring like enhancement in 2 patients.

CONCLUSIONSBilateral involvement, homogeneous density, and slight enhancement are characteristics of tonsil involvement of non Hodgkin's lymphoma. Bilateral upper groups of cervical lymph nodes are the most frequently involved lymph nodes, which are often shown with homogeneous density and slight enhancement.

Adolescent ; Adult ; Aged ; Female ; Head and Neck Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; diagnostic imaging ; pathology ; Lymphoma, Non-Hodgkin ; diagnosis ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Neck ; Neoplasm Invasiveness ; Palatine Tonsil ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND AND OBJECTIVEConcurrent chemoradiation therapy (CCRT) is the standard treatment for patients with locally advanced nasopharyngeal carcinoma (NPC). The effect of neoadjuvant chemotherapy followed by CCRT has not been determined. Therefore, we conducted 2 phase II studies to evaluate the efficacy and safety of neoadjuvant chemotherapy with a regimen of docetaxel, cisplatin, and 5 fluorouracil (5-Fu) (TPF) followed by radiotherapy and concurrent cisplatin in patients with stage III and IV(A - B) NPC. This article is the preliminary report on treatment related toxicities and response.

METHODSGraded according to the 2002 American Joint Committee on Cancer (AJCC) staging criteria, only patients with stage III or IV(A-B) poorly differentiated or undifferentiated NPC (World Health Organization type II/III) were included. We planned to recruit 52 patients with stage III disease and 64 patients with stage IV(A - B) disease. All patients received neoadjuvant chemotherapy with TPF (docetaxel 75 mg/m(2), day 1; cisplatin 75 mg/m(2), day 1; 5 Fu 500 mg/(m2 x day), continuous intravenous infusion for 120 h), every 3 weeks for 3 cycles, followed by weekly cisplatin (40 mg/m(2)) concurrent with radiotherapy. Three dimensional conformal radiotherapy (3D CRT) and intensity modulated radiotherapy (IMRT) were used. Gross disease planning target volume (PTV), high risk and low risk subclinical PTV doses were prescribed at 70-76 Gy, 66-70 Gy, and 60-61.25 Gy at 1.75-2.0 Gy per fraction. The lower neck or supraclavicular fields may be treated with conventional AP/PA fields for a total of 54 Gy at 1.8 Gy per fraction. Patients were evaluated for tumor response after the completion of neoadjuvant chemotherapy, and at 3 months after radiation according to the Response Evaluation Criteria In Solid Tumors (RECIST). The latest version of the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE 3.0) was used for grading all adverse events.

RESULTSFifty nine patients were evaluable for treatment response. Thirty patients had stage III disease and 29 patients had stage IV(A-B). All patients completed RT to the prescribed dose and 2 cycles of neoadjuvant chemotherapy, with 51 patients (86.4%) completing 3 cycles. A total of 50 (84.7%) and 39 patients (66.1%) completed 4 weeks and 5 weeks of cisplatin during CCRT, respectively. The overall response rate in the primary site and the neck region were 94.9% [complete response (CR) in 25.4%] and 100% (CR in 19.6%) after completing neoadjuvant chemotherapy. At 3 months after RT, the CR rates increased to 96.6% and 90.2%, respectively. After a median follow up of 14.3 months, we observed 5 treatment failures and 2 deaths. The 1 year overall survival, distant metastasis free survival, and locoregional relapse free survival rates were 100%, 95.7%, and 97.7%, respectively. The rates of grade 3/4 myelosuppression and anorexia/nausea/vomiting during neoadjuvant chemotherapy were 55.9% and 16.9%, respectively. The corresponding rates were 11.9% and 23.7% during CCRT. Grade 3/4 mucositis, skin desquamation, and xerostomia occurred in 6.8%, 44.1%, and 27.1% of patients, respectively. There were no treatment related deaths.

CONCLUSIONSNeoadjuvant chemotherapy with TPF followed by CCRT was well tolerated with a manageable toxicity profile. Preliminary results are encouraging and warrant further investigation.

Adult ; Aged ; Anemia ; chemically induced ; etiology ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Chemoradiotherapy ; adverse effects ; Chemotherapy, Adjuvant ; adverse effects ; Cisplatin ; adverse effects ; therapeutic use ; Female ; Fluorouracil ; adverse effects ; therapeutic use ; Follow-Up Studies ; Humans ; Leukopenia ; chemically induced ; etiology ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; therapy ; Nausea ; chemically induced ; etiology ; Neoadjuvant Therapy ; adverse effects ; Neoplasm Staging ; Neutropenia ; chemically induced ; etiology ; Radiotherapy, Conformal ; Radiotherapy, Intensity-Modulated ; Remission Induction ; Survival Rate ; Taxoids ; adverse effects ; therapeutic use ; Young Adult

BACKGROUND AND OBJECTIVEIn Guangxi province, from 1970s to 1990s, the mortality of primary liver cancer (PLC) ranked the first among a variety of malignant tumors. Investigating the epidemiological characteristics of PLC is very important for developing reasonable and effective treatment strategy, allocating health resources rationally, and evaluating the quality of PLC prevention and control. This study was to analyze the mortality and epidemiological characteristics of PLC in Guangxi province between 2004 and 2005.

METHODSMulti stage stratified cluster random sampling method was used to select 9 counties (cities or urban areas) as sample points. The residents' death causes between 2004 and 2005 were analyzed, and the epidemiological characteristics of PLC were investigated.

RESULTSIn the period of 2004-2005, the crude mortality of PLC was 34.39/100,000 in Guangxi province population (55.30/100,000 in men and 13.21/100,000 in women). The national population standardized mortality in 1964 was 22.17/100,000. The man to woman ratio of mortality was 4.19:1. PLC ranked as the first death cause among a variety of malignant tumors, and PLC related death accounted for 30.70% of all tumor related death cases. Age specific mortality of PLC was increased with age, rising significantly from 30 year old (from 25 year old in men and from 40 year old in women), and reached a peak at 75 year old.

CONCLUSIONSThe mortality of PLC shows a decreasing trend in Guangxi province in the early 21st century, and the starting age of PLC death peak postpones about 10 years than that in 1990s. It shows that the comprehensive prevention and control measures of PLC implemented in Guangxi province are fruitful. However, the PLC mortality in Guangxi province is still significantly higher than the national average level, and it still ranks as the first death cause in a variety of malignant tumors in Guangxi province. PLC mainly occurs in middle aged and elderly people. The prevention and treatment research of PLC still has a long way to go.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Liver Neoplasms ; epidemiology ; mortality ; Male ; Middle Aged ; Mortality ; trends ; Sex Distribution ; Young Adult

BACKGROUND AND OBJECTIVESurgery is the main therapy for patients with stage II non small cell lung cancer (NSCLC), but patients still have an unsatisfactory prognosis even though complete resection is usually possible. Adjuvant chemotherapy provides low rates of clinical benefit as well. We retrospectively analyzed prognostic factors of patients with completely resected stage II NSCLC to find patients with unfavorable factors for proper management.

METHODSClinical data of 220 patients with complete resections of stage II NSCLC at the Sun Yat sen University Cancer Center between January 1998 and December 2004 were retrospectively analyzed. Cumulative survival was analyzed by the Kaplan Meier method and compared by log rank test. Prognosis was analyzed by the Cox proportional hazards model.

RESULTSThe overall 3 and 5 year survival rates were 58.8% and 47.9%, respectively. The 3 and 5 year disease free survival rates were 45.8% and 37.0%, respectively. Of the 220 patients, 86 (39.1%) had recurrence or metastasis. A univariate analysis demonstrated that age (> 55 years), blood type, the presence of symptoms, chest pain, tumor volume (> 20 cm3), total number of removed lymph nodes (> or = 10), number of involved N1 lymph nodes (> or =3 ), total number of removed N2 lymph nodes (> 6), and the ratio of involved N1 lymph nodes (> or = 35%) were significant prognostic factors for 5 year survival. In the multivariate analysis, age (> 55 years), chest pain, tumor volume (> 20 cm3), total number of removed lymph nodes (> or = 10), and number of involved N1 lymph nodes (> or = 3) were independent prognostic factors for 5 year survival.

CONCLUSIONSFor patients with completely resectable stage II NSCLC, having > 55 years, presenting chest pain, tumor volumes > 20 cm3, and > or = 3 involved N1 lymph nodes were adverse prognostic factors, and > or = 10 removed lymph nodes was a favorable one. Patients with poor prognoses might be treated by individual adjuvant therapy for better survival.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; complications ; drug therapy ; pathology ; radiotherapy ; surgery ; Chemotherapy, Adjuvant ; Chest Pain ; etiology ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; complications ; drug therapy ; pathology ; radiotherapy ; surgery ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; methods ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Rate ; Tumor Burden

Asian Continental Ancestry Group ; genetics ; Ethnic Groups ; genetics ; Female ; Genetics, Population ; Humans ; Male ; Nasopharyngeal Neoplasms ; epidemiology ; ethnology

Nasopharyngeal cancer (NPC) is endemic in Southern China, with Guandong province and Hong Kong reporting some of the highest incidences in the world. The journal Science has called it a "Cantonese cancer". We propose that in fact NPC is a cancer that originated in the Bai Yue ("proto Tai Kadai" or "proto Austronesian" or "proto Zhuang") peoples and was transmitted to the Han Chinese in southern China through intermarriage. However, the work by John Ho raised the profile of NPC, and because of the high incidence of NPC in Hong Kong and Guangzhou, NPC became known as a Cantonese cancer. We searched historical articles, articles cited in PubMed, Google, monographs, books and Internet articles relating to genetics of the peoples with high populations of NPC. The migration history of these various peoples was extensively researched, and where possible, their genetic fingerprint identified to corroborate with historical accounts. Genetic and anthropological evidence suggest there are a lot of similarities between the Bai Yue and the aboriginal peoples of Borneo and Northeast India; between Inuit of Greenland, Austronesian Mayalo Polynesians of Southeast Asia and Polynesians of Oceania, suggesting some common ancestry. Genetic studies also suggest the present Cantonese, Minnans and Hakkas are probably an admixture of northern Han and southern Bai Yue. All these populations have a high incidence of NPC. Very early contact between southern Chinese and peoples of East Africa and Arabia can also account for the intermediate incidence of NPC in these regions.
Asia, Southeastern ; epidemiology ; Asian Continental Ancestry Group ; genetics ; history ; Borneo ; epidemiology ; China ; epidemiology ; Emigration and Immigration ; history ; Ethnic Groups ; genetics ; history ; Female ; Genetic Predisposition to Disease ; epidemiology ; ethnology ; genetics ; Genetics, Population ; Greenland ; epidemiology ; History, Ancient ; Hong Kong ; epidemiology ; Humans ; Incidence ; India ; epidemiology ; Inuits ; genetics ; Male ; Nasopharyngeal Neoplasms ; epidemiology ; ethnology ; genetics ; mortality ; Oceania ; epidemiology

Catheter Ablation ; methods ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Multimodal Imaging ; Neoplasm Recurrence, Local ; diagnostic imaging ; surgery ; Nerve Sheath Neoplasms ; diagnostic imaging ; surgery ; Positron-Emission Tomography ; Retroperitoneal Neoplasms ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

Adnexa Uteri ; surgery ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Diagnosis, Differential ; Female ; Humans ; Melanoma ; drug therapy ; pathology ; secondary ; surgery ; Melanosis ; pathology ; Middle Aged ; Ovarian Neoplasms ; drug therapy ; pathology ; surgery ; Pelvic Neoplasms ; secondary ; Peritoneal Neoplasms ; secondary ; Teratoma ; drug therapy ; pathology ; secondary ; surgery