Objective:To analyze the predictive effect of tumor deposit(TD) on the prognosis of yp-stage Ⅲ rectal cancer patients, and its effect on postoperative adjuvant chemotherapy benefit.Methods:Clinical data of 338 ypⅢ stage rectal cancer patients who received multidisciplinary treatment in Union Medical College Affiliated Hospital of Fujian Medical University from 2007 to 2017 were retrospectively analyzed. All patients were divided into the TD(-) group( n=301) and TD(+ ) group( n=37). Survival analysis was conducted by Kaplan- Meier method, log-rank test and univariate prognostic analysis. Multivariate prognostic analysis was performed by Cox’s regression model. Results:The 5-year overall survival(OS), progress-free survival(PFS), and distant metastasis-free survival(DMFS) in the TD(-) group were significantly higher than those in the TD(+ ) group(59.3% vs. 42.0%, P=0.001, 79.1% vs. 55.0%, P<0.001, 55.6% vs. 38.0%, P<0.001), whereas no significant difference was observed in local recurrence-free survival(LRFS) between two groups(96.7% vs. 85.5%, P=0.679). Univariate prognostic analysis revealed that the number of TD was not correlated with the prognosis of patients( P=0.923), and postoperative adjuvant chemotherapy exerted no significant effect on the prognosis of patients in two groups( P=0.103). In multivariate analysis, TD was associated with worse OS( HR=2.343, 95% CI: 1.257-4.363, P=0.007). Conclusions:For patients with ypⅢ stage rectal cancer undergoing multidisciplinary treatment, the prognosis of patients with TD is even worse. TD is an independent predictor for survival. No benefit can be obtained from postoperative adjuvant chemotherapy regardless of the presence or absence of TD.

Objective To explore the feasibility of employing a risk category system in evaluating the treatment outcome of locoregionally advanced nasopharyngeal carcinoma (NPC) treated by intensitymodulated radiation therapy (IMRT) alone,and offering evidence for relevant perspective studies.Methods Totally 185 locoregionally advanced NPC patients were divided into high-risk and low-risk groups for evaluation and comparison.The patients who met at least one of the following criteria were defined as high-risk group and others as low-risk group:GTVnx ＞ 30 cm3;Clinical stage T4N2M0;multiple neck node metastases with 1 node size ＞4 cm,and N3 with any T stage.Results With a median follow up of 110.9 months (6.7-152.4 months),the 5-year overall survival,locoregional relapse-free survival,distant metastasis-free survival for the high-risk group vs.the low-risk group were 61.0％ vs.90.5％ (x2 =30.298,P＜0.05),78.3％ vs.91.5％ (x2 =6.352,P＜0.05)and 71.6％ vs.92.0％ (x2 =16.346,P ＜0.05).Conclusions As a simple and practicable method,the risk category system is helpful for discriminating locoregionally advanced nasopharyngeal carcinoma with different risk-group of treatment failure and in further perspective clinical research.

Background:The TNM staging system is far from perfect in predicting the survival of individual cancer patients because only the gross anatomy is considered. The survival rates of the patients who have the same TNM stage disease vary across a wide spectrum. This study aimed to develop a nomogram that incorporates other clinicopatho-logic factors for predicting the overall survival (OS) of non-metastatic nasopharyngeal carcinoma (NPC) patients after curative treatments. Methods:We retrospectively collected the clinical data of 1520 NPC patients who were diagnosed histologically between November 2000 and September 2003. The clinical data of a separate cohort of 464 patients who received intensity-modulated radiation therapy (IMRT) between 2001 and 2010 were also retrieved to examine the extensibil-ity of the model. Cox regression analysis was used to identify the prognostic factors for building the nomogram. The predictive accuracy and discriminative ability were measured using the concordance index (c-index). Results:We identiifed and incorporated 12 independent clinical factors into the nomogram. The calibration curves showed that the prediction of OS was in good agreement with the actual observation in the internal validation set and IMRT cohort. The c-index of the nomogram was statistically higher than that of the 7th edition TNM staging sys-tem for predicting the survival in both the primary cohort (0.69 vs. 0.62) and the IMRT cohort (0.67 vs. 0.63). Conclusion:We developed and validated a novel nomogram that outperformed the TNM staging system in predict-ing the OS of non-metastatic NPC patients who underwent curative therapy.