2.Comparison of the survival outcomes between primary and secondary muscle-invasive bladder cancer: a propensity score-matched study.
Waichan LOK ; Jiapeng ZHANG ; Xiaonan ZHENG ; Tianhai LIN ; Hang XU ; Ping TAN ; Qiang WEI
Chinese Medical Journal 2023;136(9):1067-1073
BACKGROUND:
Studies have classified muscle-invasive bladder cancer (MIBC) into primary (initially muscle-invasive, PMIBC) and secondary subtypes (initially non-muscle-invasive but progresses, SMIBC), for which controversial survival outcomes were demonstrated. This study aimed to compare the survival outcomes between PMIBC and SMIBC patients in China.
METHODS:
Patients diagnosed with PMIBC or SMIBC at West China Hospital from January 2009 to June 2019 were retrospectively included. Kruskal-Wallis and Fisher tests were employed to compare clinicopathological characteristics. Kaplan-Meier curves and Cox competing proportional risk model were used to compare survival outcomes. Propensity score matching (PSM) was employed to reduce the bias and subgroup analysis was used to confirm the outcomes.
RESULTS:
A total of 405 MIBC patients were enrolled, including 286 PMIBC and 119 SMIBC, with a mean follow-up of 27.54 and 53.30 months, respectively. The SMIBC group had a higher proportion of older patients (17.65% [21/119] vs. 9.09% [26/286]), chronic disease (32.77% [39/119] vs . 22.38% [64/286]), and neoadjuvant chemotherapy (19.33% [23/119] vs . 8.04% [23/286]). Before matching, SMIBC had a lower risk of overall mortality (OM) (hazard ratios [HR] 0.60, 95% confidence interval [CI] 0.41-0.85, P = 0.005) and cancer-specific mortality (CSM) (HR 0.64, 95% CI 0.44-0.94, P = 0.022) after the initial diagnosis. However, higher risks of OM (HR 1.47, 95% CI 1.02-2.10, P = 0.038) and CSM (HR 1.58, 95% CI 1.09-2.29, P = 0.016) were observed for SMIBC once it became muscle-invasive. After PSM, the baseline characteristics of 146 patients (73 for each group) were well matched, and SMIBC was confirmed to have an increased CSM risk (HR 1.83, 95% CI 1.09-3.06, P = 0.021) than PMIBC after muscle invasion.
CONCLUSIONS
Compared with PMIBC, SMIBC had worse survival outcomes once it became muscle-invasive. Specific attention should be paid to non-muscle-invasive bladder cancer with a high progression risk.
Humans
;
Retrospective Studies
;
Propensity Score
;
Cystectomy
;
Urinary Bladder Neoplasms/pathology*
;
Neoadjuvant Therapy
4.Advances in targeted therapy and immunotherapy for esophageal cancer.
Haiou YANG ; Xuewei LI ; Wenhui YANG
Chinese Medical Journal 2023;136(16):1910-1922
Esophageal cancer (EC) is one of the most common aggressive malignant tumors in the digestive system with a severe epidemiological situation and poor prognosis. The early diagnostic rate of EC is low, and most EC patients are diagnosed at an advanced stage. Multiple multimodality treatments have gradually evolved into the main treatment for advanced EC, including surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy. And the emergence of targeted therapy and immunotherapy has greatly improved the survival of EC patients. This review highlights the latest advances in targeted therapy and immunotherapy for EC, discusses the efficacy and safety of relevant drugs, summarizes related important clinical trials, and tries to provide references for therapeutic strategy of EC.
Humans
;
Immunotherapy
;
Combined Modality Therapy
;
Esophageal Neoplasms/pathology*
5.Chinese expert consensus on intra-arterial drug and combined drug administration for primary hepatocellular carcinoma.
Chinese Journal of Internal Medicine 2023;62(7):785-801
Transarterial interventional therapy is one of the most widely used treatment methods in patients with primary hepatocellular carcinoma. With the progress in interventional technology and the use of new drugs, transarterial interventional therapy has achieved favorable results in the treatment of primary hepatocellular carcinoma and has become the first choice non-surgical treatment for advanced liver cancer. However, at present, there are great differences in the drugs used in transarterial interventional treatment and the combined application of other drugs among centers, and there is no uniform consensus or guideline. Based on the latest research data and clinical practice experience, as well as the characteristics of Chinese patients, the Specialist Group of Interventional Drugs, Interventionalists Branch of the Chinese Medical Doctor Association was organized to formulate the Chinese expert consensus on intra-arterial drug and combined drug administration for primary hepatocellular carcinoma. The purpose of this consensus is to explore the efficacy and safety of drugs and drug combinations related to intra-arterial interventional therapy, the use of drugs in special populations, the management of adverse reactions, and adjuvant drugs to provide a reference for clinical practice.
Humans
;
Carcinoma, Hepatocellular/pathology*
;
Consensus
;
East Asian People
;
Liver Neoplasms/pathology*
;
Pharmaceutical Preparations
;
Infusions, Intra-Arterial/methods*
;
Antineoplastic Agents/therapeutic use*
;
Drug Therapy, Combination/methods*
6.Blue Nevus Hidden within the Nevus of Ota.
Xing LIU ; Hui-Ying ZHENG ; Fu-Min FANG ; He-Dan YANG ; Hui DING ; Yin YANG ; Yi-Ping GE ; Tong LIN
Chinese Medical Sciences Journal 2023;38(1):70-72
A 3-year-old boy presented with bluish patch and scattered blue spots on the left side of his face. After several sessions of laser treatment, the azury patch in the periorbital area became even darker. Histopathology showed many bipolar, pigment-laden dendritic cells scattered in the papillary and upper reticular dermis. Immunohistochemically, these cells were positive for S100, SOX-10, melan-A, P16, and HMB-45. The positive rate of Ki-67 was less than 5%. Finally, the lesion was diagnosed with nevus of Ota concurrent with common blue nevus. Therefore, for cases of the nevus of Ota with poor response to laser treatment, the possible coexisting diseases should be suspected.
Male
;
Humans
;
Child, Preschool
;
Nevus, Blue/pathology*
;
Nevus of Ota/therapy*
;
Skin/pathology*
;
Face
;
Skin Neoplasms/pathology*
7.Primary Ovarian Small Cell Carcinoma of Pulmonary Type: Analysis of 6 Cases and Review of 31 Cases in the Literatures.
Xu CHEN ; Hong-Ling LIU ; Jin-Sui WANG ; Feng-Hui ZHAO
Chinese Medical Sciences Journal 2023;38(2):130-137
Objective Primary ovarian small cell carcinoma of pulmonary type (SCCOPT) is a rare ovarian tumor with a poor prognosis. The platinum-based chemotherapy is the standard treatment. However, there is little research on the clinical characteristics of SCCOPT and the potential benefits of other treatments due to its low incidence. The study aims to investigate clinicopathological characteristics and treatment of SCCOPT.Methods We summarized the clinical, imaging, laboratorical and pathological characteristics of 37 SCCOPT cases, in which 6 cases were admitted to the Gansu Provincial Hospital from the year of 2008 to 2022 and 31 cases reported in 17 English and 3 Chinese literatures.Results The median age of the studied SCCOPT cases (n=37) was 56.00 (range, 22-80) years. Almost 80% of them had a stage Ⅲ or Ⅳ tumor. All patients underwent an operation and postoperative chemotherapy. Nevertheless, all cases had a poor prognosis, with a median overall survival time of 12 months. Immunohistochemically, the SCCOPT of all patients showed positive expressions of epithelial markers, such as CD56 and sex-determining region of Y chromosome-related high-mobility-group box 2 (SOX-2), and negative expressions of estrogen receptor, progesterone receptor, vimentin, Leu-7, and somatostatin receptor 2. The tumor of above 80% cases expressed synaptophysin. Only a few cases expressed neuron-specific enolase, chromogranin A, and thyroid transcription factor-1. Conclusions SCCOPT had a poor prognosis. SOX-2 could be a biomarker to be used to diagnose SCCOPT.
Female
;
Humans
;
Young Adult
;
Adult
;
Middle Aged
;
Aged
;
Aged, 80 and over
;
Carcinoma, Small Cell/pathology*
;
Carcinoma, Ovarian Epithelial
;
Ovarian Neoplasms/therapy*
;
Prognosis
8.Effectiveness of autologous hematopoietic stem cell transplantation in the treatment of high-risk neuroblastoma in children: a single-center clinical study.
Li-Hui WANG ; Kai CHEN ; Na ZHANG ; Jing-Wei YANG ; Ting ZHANG ; Jing-Bo SHAO
Chinese Journal of Contemporary Pediatrics 2023;25(5):476-482
OBJECTIVES:
To investigate the effectiveness of high-dose chemotherapy combined with autologous hematopoietic stem cell transplantation (ASCT) in the treatment of children with high-risk neuroblastoma (NB).
METHODS:
A retrospective analysis was performed on 29 children with high-risk NB who were admitted to Shanghai Children's Hospital and were treated with high-dose chemotherapy combined with ASCT from January 2013 to December 2021, and their clinical features and prognosis were analyzed.
RESULTS:
Among the 29 children treated by high-dose chemotherapy combined with ASCT, there were 18 boys (62%) and 11 girls (38%), with a median age of onset of 36 (27, 59) months. According to the International Neuroblastoma Staging System, 6 children (21%) had stage III NB and 23 children (79%) had stage IV NB, and the common metastatic sites at initial diagnosis were bone in 22 children (76%), bone marrow in 21 children (72%), and intracalvarium in 4 children (14%). All 29 children achieved reconstruction of hematopoietic function after ASCT. After being followed up for a median time of 25 (17, 45) months, 21 children (72%) had continuous complete remission and 8 (28%) experienced recurrence. The 3-year overall survival rate and event-free survival rate were 68.9%±16.1% and 61.4%±14.4%, respectively. Presence of bone marrow metastasis, neuron-specific enolase ≥370 ng/mL and positive bone marrow immunophenotyping might reduce the 3-year event-free survival rate (P<0.05).
CONCLUSIONS
Children with high-risk NB who have bone marrow metastasis at initial diagnosis tend to have a poor prognosis. ASCT combined with high-dose chemotherapy can effectively improve the prognosis of children with NB with a favorable safety profile.
Child, Preschool
;
Female
;
Humans
;
Male
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
;
Bone Marrow Neoplasms/drug therapy*
;
China
;
Combined Modality Therapy
;
Disease-Free Survival
;
Hematopoietic Stem Cell Transplantation
;
Neuroblastoma/pathology*
;
Prognosis
;
Retrospective Studies
;
Stem Cell Transplantation
;
Transplantation, Autologous
9.Clinical Research Advances of Duodenal-Type Follicular Lymphoma--Review.
Hong-Yi LI ; Jun-Dong ZHANG ; Xue-Chun LU
Journal of Experimental Hematology 2023;31(2):581-584
Duodenal-type follicular lymphoma (DFL) is a unique subtype of follicular lymphoma (FL), which often involves the second portion of duodenum (descending part of duodenum). Due to its specific pathological features, such as lack of follicular dendritic cells meshwork and disappearance of activation-induced cytidine deaminase expression, DFL presents an inert clinical course and is often confined to the intestinal tract. Inflammation-related biomarkers suggest that the microenvironment may play a likely role in the pathogenesis and favorable prognosis of DFL. Since patients generally have no obvious clinical symptoms and low progression rate, the treatment regimen for DFL is mainly observation and waiting (W&W) strategy. This study will review the latest research progress of epidemiology, diagnosis, treatment and prognosis of DFL in recent years.
Humans
;
Lymphoma, Follicular/drug therapy*
;
Duodenal Neoplasms/pathology*
;
Prognosis
;
Tumor Microenvironment
10.Expert consensus on PD-L1 expression testing in esophageal carcinoma in China.
Li Yan XUE ; Yin LI ; Jing HUANG
Chinese Journal of Oncology 2023;45(4):291-297
In recent years, immunotherapy represented by immune checkpoint inhibitors programmed death 1 (PD-1) has made great progress in the treatment of esophageal cancer and is rewriting the global paradigm for the treatment of esophageal cancer. According to current data, only a small number of patients with esophageal cancer could benefit from immunotherapy. Therefore, it is a challenge to screen the potential beneficiaries of PD-1 inhibitors. Studies have shown that the expression level of programmed death-ligand 1 (PD-L1) in esophageal cancer is closely associated with the efficacy of PD-1 inhibitors, and PD-L1 is the most important predictive biomarker of the efficacy of PD-1 inhibitors. With the clinical application of different PD-1 inhibitors and PD-L1 protein expression detection platforms, clarifying the clinical significance and timing of detection of PD-L1 protein expression in esophageal cancer, and establishing a standardized PD-L1 testing procedure, are of great significance to improve the accuracy of detection and reduce the difference between laboratories, so as to maximize the therapeutic benefits for patients. This consensus was finally reached, based on the combination of literature, expert experience, and internal discussion and voting of committee members, to provide an accurate and reliable evidence for clinicians to make decisions.
Humans
;
B7-H1 Antigen/metabolism*
;
Immune Checkpoint Inhibitors/therapeutic use*
;
Consensus
;
Esophageal Neoplasms/drug therapy*
;
Immunotherapy/methods*
;
Lung Neoplasms/pathology*

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