Objective To detect human papillomavirus (HPV) infection and HRAS,PIK3CA mutations in early laungeal squamous cell carcinoma (LSCC),and prognostic analysis regarding the clinicopathological teatures,including HPV status,was conducted.Methods A total of 186 patients with T2N0-1M0 LSCC were included in this study.HPV infection,p16INK4A expression,and PIK3CA,HRAS hot spot mutations were detected.Results 9.8 ％ (16/163) cases of high-risk HPV infection and 3.8 ％ (7/186) cases of p16INK4A overexpression were found in the cohort.Three cases of PIK3CA mutation and no HRAS mutation were found.HPV-positive cases had a significantly longer overall survival (OS) (P =0.019).N1 stage had a significantly reduced RFS (P =0.021).In multivariate analysis,HPV status was the only significantly prognostic factor for OS (RR =0.30,95 ％ CI 0.09-0.96,P =0.043).Conclusions p16 cannot be used as a surrogate biomarker of HPV status in early LSCC patients.HRAS or PIK3CA mutation is not a common event in early LSCC,and no mutation is found in HPV-positive cases.HPV status is an independent prognostic factor for survival.

Objective To explore the spread patterns of retropharyngeal lymph node (RLN) metastasis of nasopharyngeal carcinoma. Methods From July 2003 to March 2005, three hundred and three patients with nasopharyngeal carcinoma in initial treatment were enrolled in this study. All patients underwent magnetic resonance imaging (MRI) before treatment, meanwhile measured the minimal and maximal axial diameters, the longitudinal diameter and the central and craniocaudad locations of each positive RLN. Results A total number of 264 positive RLN were found in 177 patients. The minimal and maximal axial diameters and longitudinal diameter of positive RLN were 9.9, 12.9 and 22.4 mm, respectively. Ipsilateral metastatic RLN were noted as follows: two nodes in 21 patients, three nodes in 3 patients and four nodes in 1 patient. According to the longitudinal central location of 263 positive lateral RLN, the numbers of nodes at occipital bone, C1, C1/C2, C2, C2/C3 and C3 were 27, 166, 40, 23, 5 and 2, respectively; the mean minimal axial diameters of nodes were 6.8, 9.9, 12.5, 10.4, 9.3 and 8.0 mm, respectively. Conclusion Multiple metastatic ipsilateral RLN are not common in NPC. The rate of RLN metastasis shows the trend of decreasing from vertebral C1 to C3.The maximal diameters of RLN are in the C1/C2 intervertebral space, and reveal a decreasing frequency along the craniocaudal directions of occipital and vertebral C1.

Objective To analyze clinical features and treatment results of primary non-Hodgkin lymphoma of bone (PLB) and further to investigate the rational treatment. Methods Clinical data of 26 patients with PLB were analyzed. Twenty-three (88.5 %) patients received radiotherapy in combination with chemotherapy, three received chemotherapy alone, and three patients also received surgical resection. Results The pathological types of lymphoma in the patients were diffused large B-cell iymphoma (DLBCL) in 15 patients (57.7 %), small B-cell lymphoma in 1 patient(3.8 %), B-cell lymphoma with unclassified subtypes in 4 patients (15.5 %), T-cell lymphoma in 5 patients (19.3 %,among which anaplastic large cell lymphoma in 3 patients), and unclassified lymphoma in one patient (3.8 %). Of the 26 cases of PLB, 15 were at stage Ⅰ, 3 at stage Ⅱ, 3 at stage Ⅲ and 5 at stage Ⅵ. The 3- and 5-year overall survival rates were 59.16 % and 31.37 %respectively. In the eleven patients who died of lymphoma, three had Iocol-regional relapse, and nine had systemically involved lymphoma. The radiation-induced bone fracture had not been observed after local radiotherapy with median dose of 50 Gy. Conclusion Pelvis maybe a common primary site of PLB, and DLBCL type are the most observed histological subtype. The optimal treatment for PLB is radiotherapy combined with chemotherapy. Local regional radiotherapy with median dose of 50 Gy can be safe and feasible.

Objective To explore the clinical significance of PET-CT in evaluating distant metastasis and M staging of nasopharyngeal carcinoma(NPC). Methods 257 NPC patients with no prior treatment were investigated with PET-CT and conventional imaging (chest X-ray, abdominal ultrasound, and bone scan). The findings of PET-CT in diagnosing distant metastasis and M staging were compared with those of conventional imaging according to the results of biopsy and follow-up. Results PET-CT disclosed 34 of 39 patients with distant malignancy compared with 22 patients disclosed by conventional imaging. The false positive rate of PET-CT was 12.8 %. On region-based analyses, PET-CT was more effective than bone scan and chest X-ray for detecting mediastinum metastasis (x2=4.063, P =0.041) and bone metastasis (x2=5.939, P=0.015), respectively. Compared with conventional imaging, PET-CT had an impact on the M staging of 19 patients (7.4 %), of which 15 patients were truly staged and 4 patients incorrectly staged. Conclusion PET-CT is superior to MRI in evaluating distant metastasis and M staging of NPC.

ObjectiveTo examine the relationship between HIF-1αt and VEGF expression and the clinicopathological characteristics in hypopharyngeal squamous cell carcinoma. Methods The expression status of HIF-1α and VEGF were examined by immunohistochemistric method (IHC) in 62 tumor tissue and 19 paracancerous normal tissue.The relationships between the expression of HIF-1α and VEGF and clinicopathological characteristic were analyzed. Results HIF-1αt and VEGF expression were higher in hypopharyngeal carcinoma tissues than those in paracancerous normal tissues (66. 1％:26. 3％ ;x2 =18. 02,P ＜0. 05 ;67. 7％ : 31.6％ ; x2 =19.22, P ＜ 0. 05 ). The expression intensity of HIF-1 α was related to T stage, N stage and TNM stage ( x2 =4. 23,5.83,9.94,all P ＜0. 05). The expression intensity of VEGF was related to metastasis, T stage, N stage and TNM stage (x2 =5.62,7. 38,15.75,4. 29 ,all P ＜0. 05 ). There was minus relationship between overall survival and expression level of HIF-1 α and/or VEGF (x2 =29. 25, P＜0.01; x2 =24.88, P＜ 0.01 ).On multivariate analysis,HIF-1α expression and T stage were independent prognostic factors for overall survival (x2 =4.80,5.74, all P＜0. 05).ConclusionsHIF-1α and VEGF may be considered as a parameter in evaluation of progression, metastasis and prognosis of hypopharyngeal carcinoma and also may be a direction of molecular target therapy.

Objective To investigate the clinical features, effective treatment, survival and prognostic factors of second primary tongue squamous cell carcinoma (SPTSCC) after nasopharyngeal carcinoma (NPC) radiotherapy. Methods The clinical data of 35 cases with SPTSCC after NPC radiotherapy were analyzed retrospectively. Kaplan-Meier method, Log-Rank test and COX proportional hazard mode was performed for statistical analysis. Results 3-year and 5-year overall survival rates were 55 % and 47 %, respectively, lymph node metastasis rate was 5.71 %. Univariate analysis indicated that gender (χ2 = 8.89, P = 0.00), T classification (χ2= 5.58, P= 0.02), clinical stage (χ2 = 8.51, P= 0.04) and treatment methods (χ2 = 29.37, P = 0.00) were important factors of prognosis. Multivariate analysis showed that treatment methods (P = 0.00) and T classification (P = 0.03) were independent prognostic factors. Operative treatment group had better prognosis than the non-operative treatment group, the difference was statistically significant (P <0.05), male patients in the risk of SPTSCC was higher than the female patients, and the incidence of SPTSCC was increased along with extension of the time after NPC radiotherapy. Conclusion The rate of the lymph node metastasis is lower for SPTSCC after NPC radiotherapy and treatment patterns and T stage are independent prognostic factors. Long-term follow-up after NPC radiotherapy is necessary to the early diagnosis of SPTSCC, so that to give surgery or combined therapy with surgery in order to achieve a good effect.

Background:Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinico?pathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis. Methods:We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat?sen University Cancer Center between January 1993 and December 2009. The Chi?square test was used to assess the relationship between the ABO blood group and clinicopathologic characteristics. The Kaplan–Meier method was used to estimate 3?, 5?, and 10?year overall survival (OS) rates. The Cox proportional hazards model was used in univariate and multivariate analyses of OS. Results:No signiifcant association was found between the ABO blood group and clinicopathologic characteristics except for primary tumor site. The median OS for patients with blood groups A, B, AB, and O were 87.0, 80.0, 90.0, and 72.5months, respectively. The 3?, 5?, and 10?year OS rates were 82.4%, 76.0%, and 67.5% for patients with blood group A; 77.4%, 69.8%, and 58.4% for patients with blood group B; 82.2%, 73.1%, and 65.6% for patients with blood group AB; and 71.7%, 66.4%, and 55.5% for patients with blood group O, respectively. Univariate and multivariate analyses showed that the ABO blood group had signiifcant effects on prognosis in patients with laryngeal cancer. Conclusions:The ABO blood group is associated with survival in patients with laryngeal cancer. Patients with blood group O had signiifcantly shorter OS than patients with other ABO blood groups.

The most common metastasis modality of gastric cancer is the perigastric lymph node metastasis. Complete dissection of regional lymph nodes of the stomach is the core surgical treatment strategy of gastric cancer, and is closely related to the prognosis of gastric cancer patients. Infrapyloric lymph node metastasis is common in gastric cancer,and its incomplete dissection is associated with tumor recurrence. Meanwhile, anatomical variations of vessels and complex mesentery layers of infrapyloric area increase the difficulty of lymphadenectomy during the operation. So, infrapyloric lymph node (No. 6) is an important station. Based on the theory of embryonic development and complete mesogastrium excision, operation across the anatomical space among mesentery layers can ensure en bloc resection of the infrapyloric lymph nodes.

OBJECTIVETo evaluate the treatment modalities and the prognostic factors of nasal cavity carcinoma.

METHODSA retrospective study was done on 60 nasal cavity carcinoma patients treated from 1985 to 1992. Thirty-four patients received radiotherapy alone and 26 patients received surgery plus radiotherapy. Kaplan-Meier method was used to evaluate the survival, Log-rank test to assess the difference between these two groups and Cox proportional hazard model by multivariate analysis.

RESULTSThe overall 5- and 10-year survival rates were 55.9% and 36.9% respectively. The 5- and 10-year survival rates were 79.0% and 57.9% in patients with early lesions (stage I, II) and 44.1% and 26.0% in patients with advanced lesions (stage III, IV) (P = 0.005). There was no significant difference in the survival rate between radiotherapy alone and radiotherapy plus surgery (P = 0.33). Patients with squamous cell carcinoma had obviously poorer survival rate than patients with adenocarcinoma (P = 0.04). Patients with positive nodes had a lower survival rate compared with negative node patients (P = 0.09).

CONCLUSIONHistological type and clinical stage, but not method of treatment or neck node metastasis, are the important prognostic factors.

Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Nasal Cavity ; Neck ; Neoplasm Staging ; Nose Neoplasms ; diagnosis ; mortality ; radiotherapy ; surgery ; Prognosis ; Retrospective Studies ; Survival Rate

The Western China Gastric Cancer Collaboration (WCGCC) was founded in Chongqing, China in 2011. At the early stage of the collaboration, there were only about 20 centers. While now, there are 36 centers from western area of China, including Sichuan, Chongqing, Yunnan, Shanxi, Guizhou, Gansu, Qinghai, Xinjiang, Ningxia and Tibet. During the past few years, the WCGCC organized routinely gastric cancer standardized treatment tours, training courses of mini-invasive surgical treatment of gastric cancer and the clinical research methodology for members of the collaboration. Meanwhile, the WCGCC built a multicenter database of gastric cancer since 2011 and the entering and management refer to national gastric cancer registration entering system of Japan Gastric Cancer Association. During the entering and collection of data, 190 items of data have unified definition and entering standard from Japan Gastric Cancer Guidelines. Nowadays, this database included about 11 872 gastric cancer cases, and in this paper we will introduce the initial results of these cases. Next, the collaboration will conduct some retrospective studies based on this database to analyze the clinicopathological characteristics of patients in the western area of China. Besides, the WCGCC performed a prospective study, also. The first randomized clinical trial of the collaboration aims to compare the postoperative quality of life between different reconstruction methods for total gastrectomy(WCGCC-1202, ClinicalTrials.gov Identifier: NCT02110628), which began in 2015, and now this study is in the recruitment period. In the next steps, we will improve the quality of the database, optimize the management processes. Meanwhile, we will engage in more exchanges and cooperation with the Chinese Cochrane Center, reinforce the foundation of the clinical trials research methodology. In aspect of standardized surgical treatment of gastric cancer, we will further strengthen communication with other international centers in order to improve both the treatment and research levels of gastric cancer in Western China.
Cancer Care Facilities ; China ; Clinical Protocols ; standards ; Clinical Trials as Topic ; methods ; standards ; Databases, Factual ; statistics & numerical data ; trends ; Education, Medical, Continuing ; Gastrectomy ; methods ; Humans ; Minimally Invasive Surgical Procedures ; education ; Organizational Objectives ; Organizations ; statistics & numerical data ; trends ; Outcome Assessment (Health Care) ; Prospective Studies ; Quality of Life ; Randomized Controlled Trials as Topic ; Registries ; statistics & numerical data ; Research Design ; standards ; Retrospective Studies ; Stomach Neoplasms ; epidemiology ; therapy