1.Multicenter retrospective analysis of the efficacy of neoadjuvant combined with adjuvant therapy in intrahepatic cholangiocarcinoma
Xianglin SONG ; Xiaodong SHI ; Hongzhi LIU ; Jianxing ZENG ; Weiping ZHOU ; Zhangjun CHENG ; Jianying LOU ; Shuguo ZHENG ; Xinyu BI ; Jianming WANG ; Wei GUO ; Fuyu LI ; Jian WANG ; Yamin ZHENG ; Jingdong LI ; Shi CHENG ; Yao HUANG ; Yongyi ZENG
Chinese Journal of General Surgery 2025;34(2):284-297
Background and Aims:Intrahepatic cholangiocarcinoma(ICC)is a highly malignant liver tumor,with an increasing incidence worldwide,particularly in Asia.Although radical surgical resection is currently the only potentially curative treatment,the high recurrence rate and low postoperative overall survival(OS)rate of ICC remain major clinical challenges.Adjuvant therapy(AT)and neoadjuvant therapy(NAT)are important strategies to reduce postoperative recurrence and prolong OS.Several studies have shown certain efficacy of these treatments.However,the specific efficacy and safety of combined NAT and AT in ICC treatment require further validation.This study was conducted to evaluate the value of combining NAT and AT in improving the therapeutic outcomes of ICC patients through a multicenter retrospective analysis,so as to provide scientific evidence for optimizing treatment strategies.Methods:The clinicopathologic data of 576 patients with ICC who underwent radical resection and were pathologically confirmed from 13 hospitals in China between December 2011 and December 2017 were retrospectively collected.Patients were grouped based on their treatment modality:NAT+AT group,AT group,and non-NAT/AT group.The three patient groups were matched pairwise in a 1∶1 ratio using propensity score matching(PSM)to balance baseline data.The Kaplan-Meier method was used to analyze OS and disease-free survival(DFS),and subgroup analyses were conducted according to the 8th edition of the AJCC TNM staging system.Results:A total of 395 ICC patients were included in the final analysis,with 42 patients(10.6%)in the NAT+AT group,62 patients(15.7%)in the AT group,and 291 patients(73.7%)in the non-NAT/AT group.Before PSM,significant differences were observed between groups in terms of CA19-9,liver function Child-Pugh classification,intraoperative blood loss,surgical margin,differentiation grade,vascular invasion,ECOG score,and lymph node dissection ratio(all P<0.05).After PSM,there were no significant differences in baseline characteristics between the groups(all P>0.05).After matching,the median OS and DFS in the NAT+AT group were significantly better than in the AT and non-NAT/AT groups(both P<0.05),while there were no significant differences in OS and DFS between the AT and non-NAT/AT groups(both P>0.05).Subgroup analysis showed that in TNM stage I patients,DFS in the NAT+AT group was significantly better than in the non-NAT/AT group(P<0.05),but OS was not significantly different(P>0.05).In TNM stage Ⅱ and Ⅲ patients,both OS and DFS in the NAT+AT and AT groups were significantly better than in the non-NAT/AT group(both P<0.05),and DFS in the NAT+AT group was significantly better than in the AT group in TNM stage Ⅲ patients(P<0.05).Conclusion:NAT combined with AT provides better survival benefits for patients with locally advanced ICC,but its benefit for early-stage ICC patients is limited.However,the retrospective design and sample size limitations of this study may affect the stability of the results,and future large-sample,multicenter,prospective studies are needed for further validation.
2.Intrahepatic cholangiocarcinoma tumor size classification based on prognostic analysis: a retrospective multicenter study
Jiaqian CHEN ; Hongzhi LIU ; Lingtian MENG ; Weiping ZHOU ; Zhangjun CHEN ; Jianying LOU ; Shuguo ZHENG ; Xinyu BI ; Jianming WANG ; Wei GUO ; Fuyu LI ; Jian WANG ; Yamin ZHENG ; Jingdong LI ; Shi CHENG
Journal of Surgery Concepts & Practice 2025;30(4):332-338
Objective To retrospectively analyze multicenter data from domestic sources, aiming to explore the link between intrahepatic cholangiocarcinoma (ICC) tumor size and prognosis, establishing a classification system based on tumor size. Methods Between December 2011 and September 2018, 280 ICC patients from 13 hospitals were included. The tumor size prognosis cutoff was identified by the minimum P-value method, and the classification's overall survival related effectiveness was assessed by Kaplan-Meier analysis. Results All 280 patients were divided into the group of tumor maximum diameter ≤4 cm and >4 cm. Tumor size was confirmed as an independent prognosis factor by multivariate COX regression analysis (HR=2.110, 95% CI: 1.358-3.280). Conclusions The tumor size dichotomy classification system based on the Chinese patient group can expediently predict ICC prognosis and offers an important basis for selecting post-operative individualized adjuvant therapy and follow up plans.
3.Clinical observation on the treatment of chemotherapy-induced peripheral neuropathic pain with Tianchan capsule
Qing WANG ; Ting CHEN ; Jingdong GAO ; Chunlei PENG
Journal of International Oncology 2025;52(5):288-294
Objective:To observe the efficacy and safety of Tianchan capsule on chemotherapy-induced peripheral neuropathic pain (CIPNP) .Methods:A total of 120 CIPNP patients with Karnofsky performance status (KPS) score higher than 60 admitted to the Nantong Tumor Hospital, Jiangsu Province and Suzhou Hospital of Traditional Chinese Medicine from April 2023 to April 2024 were selected as study objects. Patients were divided into control group (cisplatin/paclitaxel) and observation group (cisplatin/paclitaxel+Tianchan capsule) according to random number table method, with 60 cases in each group. After 28 days of treatment, the clinical efficacy, adverse reactions, numberical rating scale (NRS) score, quality of life score, Traditional Chinese Medicine (TCM) syndrome score and neurotoxicity grading score before and after treatment were observed and compared between the two groups.Results:Twenty-eight days after treatment, the total effective rate of the control group was 0 (0/60) , while the total effective rate of the observation group was 83.33% (50/60) , with a statistically significant difference ( χ2=85.71, P<0.001) . The NRS scores of the control group before treatment and at 7, 14, and 28 days after treatment were 6.18±1.71, 6.17±1.72, 6.20±1.70 and 6.22±1.70, respectively, with no statistically significant difference ( F=-1.43, P=0.160) . The NRS scores of the observation group before treatment and at 7, 14, and 28 days after treatment were 6.05±1.76, 5.17±1.42, 3.76±1.16, and 2.00±0.80, respectively, with a statistically significant difference ( F=22.89, P<0.001) . The NRS scores of the observation group at 7, 14, and 28 days after treatment were all lower than those of the control group, with statistically significant differences (all P<0.001) . Further pairwise comparison showed that, NRS scores in the observation group gradually decreased from before treatment to after 7, 14 and 28 days of treatment (all P<0.05) . Before treatment and 7, 14, and 28 days after treatment in the control group, the KPS scores were 67.33±6.43, 67.25±6.29, 67.08±6.14 and 66.75±5.80, respectively, with no statistically significant difference ( F=2.18, P=0.340) . Before treatment and 7, 14, and 28 days after treatment in the observation group, the KPS scores were 67.17±6.49, 68.33±6.32, 71.25±7.68 and 79.42±5.30, respectively, with a statistically significant difference ( F=-19.33, P<0.001) . The KPS scores of the observation group at 14 and 28 days after treatment were both higher than those of the control group, with statistically significant differences ( t=-3.33, P<0.001; t=-12.66, P<0.001) . Further pairwise comparison showed that, the KPS scores of the observation group were higher at 28 days after treatment compared to pre-treatment levels, as well as to those at 7 and 14 days after treatment (all P<0.05) . The scores of TCM syndrome showed that the scores of burnout and fatigue were 3.03±0.66 before treatment and 3.03±0.66 after 28 days of treatment in the control group, respectively, with no statistically significant difference ( t<0.01, P>0.999) . In the observation group, the scores were 3.02±0.60 and 1.97±0.52, respectively, with a statistically significant difference ( t=21.00, P<0.001) . The scores of hypochondriac pain were 3.05±0.68 before treatment and 3.07±0.63 after 28 days of treatment in the control group, respectively, with no statistically significant difference ( t=-0.57, P=0.568) . In the observation group, the scores were 3.03±0.66 and 2.02±0.57, respectively, with a statistically significant difference ( t=18.25, P<0.001) . The scores of pale complexion were 2.87±0.50 and 2.85±0.48 in the control group before treatment and 28 days after treatment, respectively, with no statistically significant difference ( t=-0.57, P=0.568) . In the observation group, the scores were 2.93±0.55 and 1.93±0.55, respectively, with a statistically significant difference ( t=24.29, P<0.001) . The scores of loss of appetite were 2.90±0.60 and 2.90±0.63 in the control group before treatment and after 28 days of treatment, respectively, with no statistically significant difference ( t<0.01, P>0.999) . In the observation group, the scores were 2.95±0.57 and 1.98±0.60, respectively, with a statistically significant difference ( t=20.42, P<0.001) . After 28 days of treatment, the scores of burnout and fatigue, hypochondriac pain, pale complexion and loss of appetite in the observation group were lower than those in the control group (all P<0.001) . Comparison of neurotoxicity grading showed that the scores of peripheral sensory nerve disorder were 2.54±0.50 before treatment and 2.58±0.49 after 28 days of treatment in the control group, respectively, with no statistically significant difference ( t=-0.40, P=0.690) . The scores in the observation group were 2.52±0.50 and 2.00±0.00, respectively, with a statistically significant difference ( t=7.29, P<0.001) . The scores of peripheral motor nerve disorder were 2.44±0.51 before treatment and 2.36±0.48 after 28 days of treatment, respectively, with no statistically significant difference ( t=0.81, P=0.419) . In the observation group, the scores were 2.46±0.50 and 2.00±0.10, respectively, with a statistically significant difference ( t=6.49, P<0.001) . Neuralgia score: Before treatment and after 28 days of treatment, the scores in the control group were 2.14±0.49 and 2.18±0.48, respectively, with no statistically significant difference ( t=-0.41, P=0.683) . The scores in the observation group were 2.16±0.51 and 1.72±0.46, respectively, with a statistically significant difference ( t=4.56, P<0.001) . After 28 days of treatment, the scores of peripheral sensory nerve disorder, peripheral motor nerve disorder and neuralgia in the observation group were lower than those in the control group (all P<0.001) . Patients in both control group and observation group had different degrees of diarrhea, nausea and vomiting, but there was no statistically significant difference in total incidence of adverse reactions between the two groups ( χ2=0.22, P=0.637) . Conclusions:Tianchan capsule can effectively reduce the pain degree of patients with CIPNP, improve the quality of life of patients and has good safety.
4.Prognostic analysis of postoperative adjuvant therapy for hepatocellular carcinoma after con-version therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy: a multicenter study
Kongying LIN ; Jia LIN ; Zisen LAI ; Yongping LAI ; Kui WANG ; Jinhong CHEN ; Zhibo ZHANG ; Jingdong LI ; Sheng TAI ; Shifeng WANG ; Siming ZHENG ; Jianxi ZHANG ; Lu ZHENG ; Kai WANG ; Jiacheng ZHANG ; Jiahui LYU ; Liming HUANG ; Yongyi ZENG
Chinese Journal of Digestive Surgery 2025;24(1):103-112
Objective:To investigate the prognosis of postoperative adjuvant therapy for hepatocellular carcinoma after conversion therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 103 patients with initially unresectable hepatocellular carcinoma (HCC) who were admitted to 11 medical centers in China, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from November 2019 to May 2023 were collected. There were 83 males and 20 females, aged (54±12)years. All 103 patients underwent conversion therapy of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) successfully followed by sequential hepatectomy, of which 72 patients undergoing postoperative adjuvant therapy were divided into the adjuvant therapy group, and 31 patients undergoing postoperative follow-up monitoring were divided into the follow-up monitoring group. Observation indicators: (1) follow-up and postoperative condi-tions; (2) analysis of factors influencing recurrence-free survival time of patients; (3) stratified ana-lysis. Comparison of count data between group was conducted using the chi-square test or Fisher exact probability. The R software was used to draw survival curves, and the Log-rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the Cox proportional hazard model. Results:(1) Follow-up and postoperative conditions. All 103 patients were followed up for 21.0(range, 1.9?47.2)months, with the median recurrence-free survival time of 28.7 months and the 1-, 2-, 3-year recurrence-free survival rates of 68.6%, 55.6%, 41.2%. The median overall survival time of 103 patients was unreached, and the 1-, 2-, 3-year overall survival rates were 90.9%, 82.1%, 69.6%, respectively. The median recurrence-free survival time was 33.1 months in patients of the adjuvant therapy group, with the 1-, 2-year recurrence-free survival rates as 77.2%, 61.5%. The median recurrence-free survival time was 11.1 months in patients of the follow-up monitoring group, with the 1-, 2-year recurrence-free survival rates as 46.6%, 40.8%. There was a significant difference in recurrence-free survival between the two groups of patients ( χ2=5.492, P<0.05). (2) Analysis of factors influencing recurrence-free survival time of patients. Results of multivariate analy-sis showed that pathologic complete response and postoperative adjuvant therapy were independent factors influencing recurrence-free survival time of HCC patients undergoing conversion therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy ( hazard ratio=0.297, 0.492, 95% confidence interval as 0.137?0.647, 0.268?0.903, P<0.05). (3) Stratified analysis. Of the 71 patients with non-pathologic complete response, the median recurrence-free survival time of 48 patients in the adjuvant therapy group was 24.0 months, with the 1-, 2-year recurrence-free survival rates as 67.4%, 48.8%. The median recurrence-free survival time of 23 patients with non-pathological complete response in the follow-up monitoring group was 7.4 months, with the 1-, 2-year recurrence-free survival rates as 35.0%, 26.3%. There was a significant difference in recurrence-free survival between the 48 patients with non-pathologic complete response in the adjuvant therapy group and the 23 patients with non-pathologic complete response in the follow-up monitoring group ( χ2=5.241, P<0.05). Conclusion:For HCC patients with conversion therapy of TKIs and ICIs followed by sequential hepatectomy, postoperative adjuvant therapy, compared to postoperative follow-up monitoring, can prolong the recurrence-free survival time of patients, of whom cases with non-pathologic complete response can benefit from adjuvant therapy.
5.Multicenter retrospective analysis of the efficacy of neoadjuvant combined with adjuvant therapy in intrahepatic cholangiocarcinoma
Xianglin SONG ; Xiaodong SHI ; Hongzhi LIU ; Jianxing ZENG ; Weiping ZHOU ; Zhangjun CHENG ; Jianying LOU ; Shuguo ZHENG ; Xinyu BI ; Jianming WANG ; Wei GUO ; Fuyu LI ; Jian WANG ; Yamin ZHENG ; Jingdong LI ; Shi CHENG ; Yao HUANG ; Yongyi ZENG
Chinese Journal of General Surgery 2025;34(2):284-297
Background and Aims:Intrahepatic cholangiocarcinoma(ICC)is a highly malignant liver tumor,with an increasing incidence worldwide,particularly in Asia.Although radical surgical resection is currently the only potentially curative treatment,the high recurrence rate and low postoperative overall survival(OS)rate of ICC remain major clinical challenges.Adjuvant therapy(AT)and neoadjuvant therapy(NAT)are important strategies to reduce postoperative recurrence and prolong OS.Several studies have shown certain efficacy of these treatments.However,the specific efficacy and safety of combined NAT and AT in ICC treatment require further validation.This study was conducted to evaluate the value of combining NAT and AT in improving the therapeutic outcomes of ICC patients through a multicenter retrospective analysis,so as to provide scientific evidence for optimizing treatment strategies.Methods:The clinicopathologic data of 576 patients with ICC who underwent radical resection and were pathologically confirmed from 13 hospitals in China between December 2011 and December 2017 were retrospectively collected.Patients were grouped based on their treatment modality:NAT+AT group,AT group,and non-NAT/AT group.The three patient groups were matched pairwise in a 1∶1 ratio using propensity score matching(PSM)to balance baseline data.The Kaplan-Meier method was used to analyze OS and disease-free survival(DFS),and subgroup analyses were conducted according to the 8th edition of the AJCC TNM staging system.Results:A total of 395 ICC patients were included in the final analysis,with 42 patients(10.6%)in the NAT+AT group,62 patients(15.7%)in the AT group,and 291 patients(73.7%)in the non-NAT/AT group.Before PSM,significant differences were observed between groups in terms of CA19-9,liver function Child-Pugh classification,intraoperative blood loss,surgical margin,differentiation grade,vascular invasion,ECOG score,and lymph node dissection ratio(all P<0.05).After PSM,there were no significant differences in baseline characteristics between the groups(all P>0.05).After matching,the median OS and DFS in the NAT+AT group were significantly better than in the AT and non-NAT/AT groups(both P<0.05),while there were no significant differences in OS and DFS between the AT and non-NAT/AT groups(both P>0.05).Subgroup analysis showed that in TNM stage I patients,DFS in the NAT+AT group was significantly better than in the non-NAT/AT group(P<0.05),but OS was not significantly different(P>0.05).In TNM stage Ⅱ and Ⅲ patients,both OS and DFS in the NAT+AT and AT groups were significantly better than in the non-NAT/AT group(both P<0.05),and DFS in the NAT+AT group was significantly better than in the AT group in TNM stage Ⅲ patients(P<0.05).Conclusion:NAT combined with AT provides better survival benefits for patients with locally advanced ICC,but its benefit for early-stage ICC patients is limited.However,the retrospective design and sample size limitations of this study may affect the stability of the results,and future large-sample,multicenter,prospective studies are needed for further validation.
6.Prognostic analysis of postoperative adjuvant therapy for hepatocellular carcinoma after con-version therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy: a multicenter study
Kongying LIN ; Jia LIN ; Zisen LAI ; Yongping LAI ; Kui WANG ; Jinhong CHEN ; Zhibo ZHANG ; Jingdong LI ; Sheng TAI ; Shifeng WANG ; Siming ZHENG ; Jianxi ZHANG ; Lu ZHENG ; Kai WANG ; Jiacheng ZHANG ; Jiahui LYU ; Liming HUANG ; Yongyi ZENG
Chinese Journal of Digestive Surgery 2025;24(1):103-112
Objective:To investigate the prognosis of postoperative adjuvant therapy for hepatocellular carcinoma after conversion therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 103 patients with initially unresectable hepatocellular carcinoma (HCC) who were admitted to 11 medical centers in China, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from November 2019 to May 2023 were collected. There were 83 males and 20 females, aged (54±12)years. All 103 patients underwent conversion therapy of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) successfully followed by sequential hepatectomy, of which 72 patients undergoing postoperative adjuvant therapy were divided into the adjuvant therapy group, and 31 patients undergoing postoperative follow-up monitoring were divided into the follow-up monitoring group. Observation indicators: (1) follow-up and postoperative condi-tions; (2) analysis of factors influencing recurrence-free survival time of patients; (3) stratified ana-lysis. Comparison of count data between group was conducted using the chi-square test or Fisher exact probability. The R software was used to draw survival curves, and the Log-rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the Cox proportional hazard model. Results:(1) Follow-up and postoperative conditions. All 103 patients were followed up for 21.0(range, 1.9?47.2)months, with the median recurrence-free survival time of 28.7 months and the 1-, 2-, 3-year recurrence-free survival rates of 68.6%, 55.6%, 41.2%. The median overall survival time of 103 patients was unreached, and the 1-, 2-, 3-year overall survival rates were 90.9%, 82.1%, 69.6%, respectively. The median recurrence-free survival time was 33.1 months in patients of the adjuvant therapy group, with the 1-, 2-year recurrence-free survival rates as 77.2%, 61.5%. The median recurrence-free survival time was 11.1 months in patients of the follow-up monitoring group, with the 1-, 2-year recurrence-free survival rates as 46.6%, 40.8%. There was a significant difference in recurrence-free survival between the two groups of patients ( χ2=5.492, P<0.05). (2) Analysis of factors influencing recurrence-free survival time of patients. Results of multivariate analy-sis showed that pathologic complete response and postoperative adjuvant therapy were independent factors influencing recurrence-free survival time of HCC patients undergoing conversion therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy ( hazard ratio=0.297, 0.492, 95% confidence interval as 0.137?0.647, 0.268?0.903, P<0.05). (3) Stratified analysis. Of the 71 patients with non-pathologic complete response, the median recurrence-free survival time of 48 patients in the adjuvant therapy group was 24.0 months, with the 1-, 2-year recurrence-free survival rates as 67.4%, 48.8%. The median recurrence-free survival time of 23 patients with non-pathological complete response in the follow-up monitoring group was 7.4 months, with the 1-, 2-year recurrence-free survival rates as 35.0%, 26.3%. There was a significant difference in recurrence-free survival between the 48 patients with non-pathologic complete response in the adjuvant therapy group and the 23 patients with non-pathologic complete response in the follow-up monitoring group ( χ2=5.241, P<0.05). Conclusion:For HCC patients with conversion therapy of TKIs and ICIs followed by sequential hepatectomy, postoperative adjuvant therapy, compared to postoperative follow-up monitoring, can prolong the recurrence-free survival time of patients, of whom cases with non-pathologic complete response can benefit from adjuvant therapy.
7.Clinicopathological features and prognosis of early-onset gastric cancer: a large-scale retrospective real-world study
Jingdong LIU ; Changle YANG ; Peili JIN ; Bosen LI ; Junjie ZHAO ; Haojie LI ; Xuefei WANG ; Yihong SUN
Chinese Journal of Gastrointestinal Surgery 2024;27(5):452-456
Objective:To clarify the clinicopathological features, prognosis, and recurrence pattern of early-onset gastric cancer (EOGC).Methods:Using data from the gastric cancer database of Zhongshan Hospital, Fudan University, we performed a retrospective, large-scale, real-world study of 5046 patients with gastric cancer who had undergone redical or palliative gastrectomy from January 2013 to December 2018, including 425 patients with EOGC (age ≤45 years) and 4621 controls. All those patients were pathologically confirmed adenocarcinoma with complete follow-up of five years. Residue gastric cancer and patients without complete clinical or follow-up data were excluded. We used a combination of outpatient and telephone follow-up, ending in October 2022 (median duration of follow-up 60 months), and compared the clinicopathological features and prognosis of the two groups.Results:The clinicopathological features of EOGC included female predominance (61.1% [262/425 vs. 26.3% [1217/4621], χ 2=234.215, P<0.001), fewer comorbidities (31.3% [133/425] vs. 58.5% [2703/4621], χ 2=34.378, P<0.001), poorer differentiation (90.6% [385/425] vs. 78.2% [3614/4621], χ 2=30.642, P<0.001), higher proportion of diffuse type (53.9% [229/425] vs. 18.3% [846/4621], χ 2=274.474, P<0.001), higher proportion of T4 stage (44.7% [190/425] vs. 37.5% [1733/4621], χ 2=17.535, P=0.001), more lymph node metastases (60.5% [257/425] vs. 53.9% [2491/4621], χ 2=6.764, P=0.009), and higher proportion of pathological stage III/IV (47.5% [202/425] vs. 42.4% [1959/4621], χ 2=4.093, P=0.043). The 5-year overall survival rates of the EOGC and control groups were 55.1% and 49.1%, respectively. Overall survival was significantly better in the EOGC than in the control group ( P<0.001). According to subgroup analysis, the prognosis of pathological stage I/II/III EOGC was better than that of the control group. Recurrence rates were similar in the two groups, whereas patients with EOGC had a higher proportion of peritoneal recurrence (7.8% [33/425] vs. 3.2% [146/4621], χ 2=23.741, P<0.001) and a lower proportion of distant metastasis (4.9% [21/425] vs. 8.3% [385/4621], χ 2=6.247, P=0.012). Conclusion:EOGC has unique clinicopathological features and recurrence patterns and resectable EOGC has a better prognosis, suggesting that patients with EOGC should be actively treated with the focus on preventing peritoneal recurrence.
8.Analysis on Current Status and Countermeasures for Laboratory Animal Management in Sichuan Province Based on Administrative Licensing
Bing CHEN ; Yixing ZOU ; Jingdong WANG
Laboratory Animal and Comparative Medicine 2024;44(5):560-566
Laboratory animals are indispensable strategic resources that support technological progress and innovation. At the same time, the biosafety of laboratory animals is an important component of national public health security. The production and use of laboratory animals require statutory administrative licensing. This article first summarizes the current status of management and development in Sichuan Province by reviewing the number, types, and industry distribution of license-holding facilities, the area of facilities and the status of top ten largest facilities by area, the types and quantities of laboratory animals produced, and the production capacity of certain facilities, as well as the types and quantities of laboratory animals used and the status of the top ten facilities by animal quantity. Then, it discusses the development advantages of the laboratory animal industry in Sichuan Province, including its leading industrial scale in the western region, increasing regional influence, and emerging comprehensive benefits. However, there are significant issues such as the inability of laboratory animal production to adequately meet the demand, the need to improve the level of technological innovation, and the challenges of ensuring animal safety management. Finally, corresponding countermeasures suggestions are proposed, including actively supporting the improvement of quality and efficiency of laboratory animal production, establishing a stable support mechanism for technological innovation, and placing a strong emphasis on animals safety management. This article aims to provide a reference for further improving the management level and industry development momentum of laboratory animals in Sichuan Province and other provinces.
9.Research on Management Policies of Laboratory Animals in Sichuan Province
Bing CHEN ; Yixing ZOU ; Lingyun YAO ; Jingdong WANG
Laboratory Animal and Comparative Medicine 2024;44(2):209-213
Improving laboratory animal management system is one of the effective ways to promote the legalization and standardization of laboratory animal management. This article systematically reviews the relevant content and requirements of the latest laws, regulations, normative documents, and standards formulated and promulgated by the state since 2019 regarding the management of experimental animals. It also analyzes the current institutional framework in managing experimental animals in Sichuan Province from four aspects: administrative management, quality assurance, biosafety, and local standards. Furthermore, this article summarizes the existing problems and proposes corresponding policy recommendations in a targeted manner, aiming to provide a reference for the formulation of robust experimental animal management policies in Sichuan Province.
10.Clinicopathological features and prognosis of early-onset gastric cancer: a large-scale retrospective real-world study
Jingdong LIU ; Changle YANG ; Peili JIN ; Bosen LI ; Junjie ZHAO ; Haojie LI ; Xuefei WANG ; Yihong SUN
Chinese Journal of Gastrointestinal Surgery 2024;27(5):452-456
Objective:To clarify the clinicopathological features, prognosis, and recurrence pattern of early-onset gastric cancer (EOGC).Methods:Using data from the gastric cancer database of Zhongshan Hospital, Fudan University, we performed a retrospective, large-scale, real-world study of 5046 patients with gastric cancer who had undergone redical or palliative gastrectomy from January 2013 to December 2018, including 425 patients with EOGC (age ≤45 years) and 4621 controls. All those patients were pathologically confirmed adenocarcinoma with complete follow-up of five years. Residue gastric cancer and patients without complete clinical or follow-up data were excluded. We used a combination of outpatient and telephone follow-up, ending in October 2022 (median duration of follow-up 60 months), and compared the clinicopathological features and prognosis of the two groups.Results:The clinicopathological features of EOGC included female predominance (61.1% [262/425 vs. 26.3% [1217/4621], χ 2=234.215, P<0.001), fewer comorbidities (31.3% [133/425] vs. 58.5% [2703/4621], χ 2=34.378, P<0.001), poorer differentiation (90.6% [385/425] vs. 78.2% [3614/4621], χ 2=30.642, P<0.001), higher proportion of diffuse type (53.9% [229/425] vs. 18.3% [846/4621], χ 2=274.474, P<0.001), higher proportion of T4 stage (44.7% [190/425] vs. 37.5% [1733/4621], χ 2=17.535, P=0.001), more lymph node metastases (60.5% [257/425] vs. 53.9% [2491/4621], χ 2=6.764, P=0.009), and higher proportion of pathological stage III/IV (47.5% [202/425] vs. 42.4% [1959/4621], χ 2=4.093, P=0.043). The 5-year overall survival rates of the EOGC and control groups were 55.1% and 49.1%, respectively. Overall survival was significantly better in the EOGC than in the control group ( P<0.001). According to subgroup analysis, the prognosis of pathological stage I/II/III EOGC was better than that of the control group. Recurrence rates were similar in the two groups, whereas patients with EOGC had a higher proportion of peritoneal recurrence (7.8% [33/425] vs. 3.2% [146/4621], χ 2=23.741, P<0.001) and a lower proportion of distant metastasis (4.9% [21/425] vs. 8.3% [385/4621], χ 2=6.247, P=0.012). Conclusion:EOGC has unique clinicopathological features and recurrence patterns and resectable EOGC has a better prognosis, suggesting that patients with EOGC should be actively treated with the focus on preventing peritoneal recurrence.

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