Objective:To explore the prognostic factors that may affect the postoperative survival of gastric cancer by analyzing patients with radical gastrectomy.Methods:The data of 525 patients with radical gastrectomy, including 387 male and 138 female with average age (62.5±10.7) years old (ranged from 16 to 89 years), were analyzed retrospectively in Anqing Municipal Hospital between October 2010 to July 2015. The relationship between 33 variables and prognosis was analyzed by a Cox proportionalhazards regression model, meanwhile ROC curve was established in order to explore the risk factor of postopertive survival.Results:The over survival(OS) rate of all patients was 89.3% at 1 year, 68.4% at 3 years and 59.6% at 5 years. The 5-year OS rate was 81.9% at stage Ⅰ, 71.4% at stage Ⅱ and 44.1% at stage Ⅲ. In the multivariate analysis that included these factors, preoperative comorbidity ( HR=1.595, P=0.001), hemoglobin( HR=1.377, P=0.017), CA199( HR=1.618, P=0.004), tumor distribution( HR=1.943, P=0.032), pT stage( HR=1.731, P=0.012), pN stage( HR=2.118, P=0.000), signet ring cell( HR=1.642, P=0.038)and intravascular tumor thrombus( HR=1.391, P=0.039) were independent risk factors associating with postopertive survival.According to ROC curve, the following area (AUC value) could predict survival after radical gastrectomy, including CA199 (AUC=0.568), hemoglobin(AUC=0.586), preoperative comorbidity(AUC=0.554), pT stage(AUC=0.636), pN stage(AUC=0.670)and intravascular tumor thrombus(AUC=0.626)( P<0.05). Conclusion:According to ROC curve analysis, preoperative comorbidity, anemia, CA199, pN stage, pT stage and intravascular tumor thrombus played an role in predicting long-term survival after radical resection of gastric cancer.

Objective:Clavien-Dindo grading system was used to explore the occurrence and related risk factors of early severe complications after radical resection of gastric cancer, and the effect of severe complications on long-term prognosis was analyzed.Methods:The clinical data of 525 patients who underwent radical resection of gastric cancer, including 387 male and 138 female with average age(62.5±10.7)years old (range from 16 to 89 years), were analyzed retrospectively in Department of Surgical Oncology of Anqing Municipal Hospital from October 2010 to July 2015. The occurrence of postoperative severe complications was analyzed according the Clavien-Dindo grade system.The relationship between 18 variables and severe complications was analyzed by univariate and multivariate analysis in order to explore the risk factors of severe postoperative complications, and the relationship between severe complications and long-term prognosis was analyzed by COX survival model. The software of SPSS 17.0 was used to conduct statistic analysis.Results:Five hundred and twenty-five patients with radical gastrectomy, 114 cases had early postoperative complications, including 20 cases of severe complications, 4 cases were performed second surgery under general anesthesia. The results of univariate analysis showed gender( χ2=4.86, P=0.027), the amount of bleeding( χ2=11.11, P=0.001), opertive time( χ2=4.77, P=0.029), the mode of operation( χ2=9.20, P=0.002) and pTNM stage( χ2=4.86, P=0.027) had significant statistical difference. Multivariate analysis showed that the amount of bleeding ( OR=13.05, P=0.013) and the mode of operation ( OR=7.97, P=0.047) were independent risk factors for early and severe complications after radical resection of gastric cancer. The 5-year survival rates of severe complication and non-severe complication were 35.0% and 61.8% respectively, and the difference was statistically significant ( P=0.004). Severe postoperative complications ( HR=1.595, P=0.107) were not independent risk factors affecting the 5-year survival rate. Conclusions:Early severe complications after radical resection of gastric cancer are closely related to intraoperative blood loss and total gastrectomy. Although the 5-year survival rate in severe complication group is significantly lower than that in non-severe complication group, severe complication is not an independent risk factor for long-term survival.

Objective:To analyse the clinical application value of Lone-Star perineal exposure technique in performing abdominal perineal resection (APR).Methods:Conducted a retrospective review of 17 rectal cancer patients, including 13 males, 4 females, aged from 44 to 82 years old, with the average age of (67.6±9.7) years who underwent APR at Anqing Municipal Hospital from January 2020 to July 2024. The Lone-Star retractor-assisted (LSR) exposure method was employed for the perineal operation. After incising the skin and subcutaneous tissue, a Lone-Star retractor was utilized, with eight small hooks used to extend the incision in multiple directions, facilitating the release of deep tissues. The hooks were dynamically adjusted to optimize surgical field exposure.Results:All 17 patients were successfully underwent laparoscopic-assisted APR. Fifteen operations were independently performed by a single surgeon, while 2 required assistance for intraoperative arterial hemostasis. No perforations occurred, and all specimens had a negative circumferential resection margin (CRM). Postoperative complications were observed in 4 patients, including urinary retention in one, pulmonary infection in one, wound seroma in one, and stoma mucosal detachment in one, all of which were classified as Clavien-Dindo grade 3 or lower and cured.Conclusions:The LSR exposure technique may significantly improve perineal exposure during APR for rectal cancer. It could potentially enhance intraoperative safety and efficiency, and facilitate single-operator surgery.

Objective:To investigate the relationship between clinicopathological features and lymph node metastasis(LNM)of early gastric cancer(EGC), so as to provide and theoretical guidance for the normative treatment of EGC.Methods:A retrospective analysis was performed on 128 patients with EGC who received surgical treatment from January 2016 to December 2019 in Anhui Medical University Affiliated Anqing hospital.Results:The total LNM ratio of EGC was 10.1% (13/128). Univariate analysis showed that the LNM ratio was 18.0% in patients with the largest diameter of >2 cm, higher than 5.1% in patients with the largest diameter of ≤2 cm. The LNM ratio of submucosal carcinoma (T 1b) was 21.6%, higher than 2.6% of intramucosal carcinoma (T 1a). The LNM ratio of patients with vascular invasion was 71.4%, higher than 6.7% of patients without vascular invasion. The LNM ratio was 13.1% in the total dissected lymph node group ≥15, higher than 0 in the total dissected lymph node group <15. The difference between the these groups was statistically significant( χ2=5.532, 12.101, 23.778, 4.239, P<0.05). There was no significant difference in the correlation between age, gender, tumor site, general type, degree of differentiation, and the LNM of EGC ( P>0.05). Multivariate analysis showed that submucosal carcinoma(RR=10.688, 95% CI: 1.714-66.651, P=0.011) and vascular infiltration(RR=27.209, 95% CI: 3.749-197.450, P=0.001) were the independent risk factor for the LNM of EGC. Conclusions:Patients of EGC with tumor infiltration to submucosa(T 1b), maximum diameter of lesion >2 cm, and vascular infiltration have a higher risk of LNM. Standardized D1+ or D2 lymph node dissection (≥15) should be performed for EGC patients.

Objective To investigate the modified Clavien-Dindo classification and risk factors for postoperative early complications of radical proctectomy in rectal cancer.Methods The clinical data of 187 patients,including 99 male cases and 88 female cases with the average age (64.5 ± 10.8) years old (ranged from 37 to 87 years),with radical resection of rectal cancer were analyzed retrospectively in Anqing Hospital Affiliated of Anhui Medical University between August 2014 and October 2018,and the occurrence of early postoperative complications was analyzed according to the modified Clavien-Dindo grade system.The relationship between 32 variables and complications in the data was analyzed by single factor and multiple factors in order to explore the risk factors of early postoperative complications.Results One hundred and eighty seven patients with radical proctectomy,54 cases (28.9％,54/187) had early postoperative complications,including 15 cases of serious complications (8.0％,15/187),3 cases were performed second surgeries under general anesthesia (1.6％,3/187).Postoperative modified Clavien-Dindo Grade:12 cases with grade Ⅰ,27 cases with grade Ⅱ,11 cases with grade Ⅲ a,3 cases with grade Ⅲ b,1 case with grade Ⅳ a,no case with grade Ⅳ b and Ⅴ.The results of single factor analysis showed age (x2 =4.788,P =0.029),ASA grade (x2 =26.903,P =0.000),multiple organ resection (x2 =4.749,P =0.029),pT stage (x2 =8.080,P =0.044),pTNM stage (x2 =6.29,P =0.043),total harvested lymph node number (x2 =5.542,P =0.019).The occurrence of early complications after radical proctectomy,multi-factor analysis found that ASA grade (OR =3.539,P =0.000),pTNM stage (OR =1.846,P =0.034) was an independent risk factor for early postoperative complications of rectal cancer.The area (AUC value) under the curve of the prediction of early postoperative complications in patients with ASA grade and pTNM stage was 0.708 (95％ CI:0.625-0.791,P =0.000) and 0.555 (95％ CI:0.469-0.642,P =0.235).Conclusions Early complications after radical resection of rectal cancer are closely related to ASA grade and tumor pTNM staging.ASA grade can be used as a significant predictor of early complications after radical proctectomy in rectal cancer.

Objective To investigate the expression and clinical significance of mismatch repair (MMR) protein,human epidermal growth factor receptor (HER)2 and Ki-67 in colorectal cancer.Methods The clini-cal data of 559 patients with colorectal cancer who underwent surgical treatment in the hospital from October 2017 to May 2022 were retrospectively analyzed.The expressions of MMR protein (MLH1,MSH2,PMS2, MSH6),HER2 and Ki-67 in colorectal cancer were detected by immunohistochemistry,and the relationship between them and the clinicopathological features of colorectal cancer was analyzed.Results Among the 559 patients with colorectal cancer,43 cases (7.7％) were deficient mismatch repair (dMMR),8 cases(1.4％) were HER2 +++,and 251 cases (44.9％) were Ki-67 +++.The expression rate of dMMR in the colorec-tal cancer patients with different age,tumor location,tumor maximum diameter,gross type,histological grade,lymph node metastasis and TNM stage was significantly different (P<0.05).The expression rate of HER2 ++/+++ in the patients with different gross types of colorectal cancer was statistically significant (P<0.05).The expression rate of Ki-67 +++ in the colorectal cancer patients with different histological types,histological grades,lymph node metastasis,distant metastasis and TNM staging was statistically signifi-cant (P<0.05).There was no correlation between MMR protein and the expression of HER2 and Ki-67 (P>0.05).Conclusion The expression of MMR proteins in colorectal cancer is closely related to its clinicopatho-logical features.