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Adjuvant treatment strategy after curative resection for hepatocellular carcinoma

Wei Zhang, Bixiang Zhang, Xiao-ping Chen

《医学前沿（英文）》 2021年 第15卷 第2期   页码 155-169 doi: 10.1007/s11684-021-0848-3

摘要： Hepatic resection represents the first-line treatment for patients with resectable hepatocellular carcinoma (HCC). However, the 5-year recurrence rates of HCC after surgery have been reported to range from 50% to 70%. In this review, we evaluated the available evidence for the efficiency of adjuvant treatments to prevent HCC recurrence after curative liver resection. Antiviral therapy has potential advantages in terms of reducing the recurrence rate and improving the overall survival (OS) and/or disease-free survival of patients with hepatitis-related HCC. Postoperative adjuvant transarterial chemoembolization can significantly reduce the intrahepatic recurrence rate and improve OS, especially for patients with a high risk of recurrence. The efficacy of molecular targeted drugs as an adjuvant therapy deserves further study. Adjuvant adoptive immunotherapy can significantly improve the clinical prognosis in the early stage. Randomized controlled trial (RCT) studies evaluating adjuvant immune checkpoint inhibitors are ongoing, and the results are highly expected. Adjuvant hepatic artery infusion chemotherapy might be beneficial in patients with vascular invasion. Huaier granule, a traditional Chinese medicine, has been proved to be effective in prolonging the recurrence-free survival and reducing extrahepatic recurrence. The efficiency of other adjuvant treatments needs to be further confirmed by large RCT studies.

关键词： hepatocellular carcinoma     adjuvant treatment     hepatic resection     recurrence    

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Prevention and treatment of pancreatic fistula after pancreatic body and tail resection: current status

Li Jiang, Deng Ning, Xiaoping Chen

《医学前沿（英文）》 2020年 第14卷 第3期   页码 251-261 doi: 10.1007/s11684-019-0727-3

摘要： Postoperative pancreatic fistula (POPF) is the most common and critical complication after pancreatic body and tail resection. How to effectively reduce the occurrence of pancreatic fistula and conduct timely treatment thereafter is an urgent clinical issue to be solved. Recent research standardized the definition of pancreatic fistula and stressed the correlation between POPF classification and patient prognosis. According to the literature, identification of the risk factors for pancreatic fistula contributed to lowering the rate of the complication. Appropriate management of the pancreatic stump and perioperative treatment are of great significance to reduce the rate of POPF in clinical practice. After the occurrence of POPF, the treatment of choice should be determined according to the classification of the pancreatic fistula. However, despite the progress and promising treatment approaches, POPF remains to be a clinical issue that warrants further studies in the future.

关键词： pancreatic fistula     pancreatic body and tail resection     distal pancreatectomy    

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loaded natural extracellular matrix hydrogel for inhibition of glioblastoma recurrence after tumor resection

《化学科学与工程前沿（英文）》 2022年 第16卷 第4期   页码 536-545 doi: 10.1007/s11705-021-2067-5

摘要： Many scientific efforts have been made to penetrate the blood-brain barrier and target glioblastoma cells, but the outcomes have been limited. More attention should be given to local inhibition of recurrence after glioblastoma resection to meet real medical needs. A biodegradable wafer containing the chemotherapeutics carmustine (1,3-bis(2-chloroethyl)-1-nitrosourea, BCNU) was the only local drug delivery system approved for clinical glioblastoma treatment, but with a prolonged survival time of only two months and frequent side effects. In this study, to improve the sustained release and prolonged therapeutic effect of drugs for inhibiting tumor recurrence after tumor resection, both free BCNU and BCNU- poly (lactic-co-glycolic acid) (the ratio of lactic acid groups to glycolic acid groups is 75/25) nanoparticles were simultaneously loaded into natural extracellular matrix hydrogel from pigskin to prepare BCNU gels. The hydrogel was injected into the resection cavity of a glioblastoma tumor immediately after tumor removal in a fully characterized resection rat model. Free drugs were released instantly to kill the residual tumor cells, while drugs in nanoparticles were continuously released to achieve a continuous and effective inhibition of the residual tumor cells for 30 days. These combined actions effectively restricted tumor growth in rats. Thus, this strategy of local drug implantation and delivery may provide a reliable method to inhibit the recurrence of glioblastoma after tumor resection in vivo.

关键词： BCNU     glioblastoma recurrence     tumor resection     nanoparticles     hydrogel    

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Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors

null

《医学前沿（英文）》 2012年 第6卷 第3期   页码 317-321 doi: 10.1007/s11684-012-0203-9

摘要：

In order to find out the potential indicators predicting prognosis of malignant gastrointestinal stromal tumors (GISTs) after surgical resection, we collected clinical records of 80 patients with malignant GISTs. Tumor location, size, mitotic index, necrosis were compared with the prognosis of malignant GISTs by Kaplan-Meier method and log-rank test. After a median follow-up of 844 days (52–2 145), we found that as National Institutes of Health suggested, tumors with intermediate risk had more favorable prognosis than that with high risk. Their 3-year survival rate were 65.3% and 41.3%, respectively (P<0.001). Moreover, tumor size and mitotic index were associated with free survival. The 3-year survival rate for patients with tumor size≤10 cm and>10 cm were 62.3% and 41.8%, respectively (P = 0.002), Tumors with mitotic index≤5/50 HPF had a higher 3-year survival rate than tumors with mitotic index>5/50 HPF (67.1% versus 40.7%, P = 0.005). The presence of necrosis was directly related to the malignant behavior. The 3-year survival rate for presence and absence necrosis were 50.8% and 64.8% (P = 0.008). From the present study, we can conclude that besides tumors size and mitotic index, tumor location and necrosis also influence on the long-term survival of patient with malignant GISTs after surgical resection.

关键词： gastrointestinal stromal tumors     surgery     survival    

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Endoscopic resection of a huge Brunner's gland adenoma

ZHANG Binbin, REN Xu, TANG Xiufen, CHI Yuxin, SHI Xuesong

《医学前沿（英文）》 2008年 第2卷 第4期   页码 414-418 doi: 10.1007/s11684-008-0080-4

摘要： Brunner’s gland adenoma is a rare tumour of the duodenum, which is usually benign. A 71-year-old woman presenting with epigastric pain, upper gastrointestinal haemorrhage and melaena was reported in this paper. Upper gastro-intestinal (GI) endoscopy revealed a large pedunculated tumour on the superior part of the duodenal bulb. Endoscopic polypectomy was successfully performed by clipping and nylon thread without any complications. Histological examination revealed a Brunner’s gland adenoma.

关键词： superior     Histological examination     endoscopy     gastro-intestinal     gastrointestinal haemorrhage    

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Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

GU Jin, YAO Yunfeng, LI Jiyou, LU Aiping, WANG Hongyi

《医学前沿（英文）》 2007年 第1卷 第3期   页码 333-337 doi: 10.1007/s11684-007-0064-9

摘要： It is difficult to distinguish a rectal carcinoma with anal metastases from coexistent synchronous anorectal carcinomas. The therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly identified. Here, we report on the case of a 63-year-old man who presented with an upper-third rectal adenocarcinoma. Five months after resection, he developed an adenocarcinoma in the anal canal. The histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins (CKs) 7 and 20 were performed. The index tumor demonstrated CK 7 /CK 20+ and the second showed CK7+/CK20+. For this reason, we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum separately. It is very important to differentiate the anorectal lesions pathologically because of the impact on the therapeutic options available, especially for the lesion arising in the anal canal.

关键词： CK7+/CK20+     resection     different     therapeutic strategy     upper-third    

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Post-surgical resection prognostic value of combined OPN, MMP7, and PSG9 plasma biomarkers in hepatocellular

Weiqi Rong, Yang Zhang, Lei Yang, Lin Feng, Baojun Wei, Fan Wu, Liming Wang, Yanning Gao, Shujun Cheng, Jianxiong Wu, Ting Xiao

《医学前沿（英文）》 2019年 第13卷 第2期   页码 250-258 doi: 10.1007/s11684-018-0632-1

摘要： Biomarkers for hepatocellular carcinoma (HCC) following curative resection are not currently sufficient for prognostic indication of overall survival (OS) and disease-free survival (DFS). The aim of this study was to investigate the prognostic performance of osteopontin (OPN), matrix metalloproteinase 7 (MMP7), and pregnancy specific glycoprotein 9 (PSG9) in patients with HCC. A total of 179 prospective patients with HCC provided plasma before hepatectomy. Plasma OPN, MMP7, and PSG9 levels were determined by enzyme-linked immunosorbent assay. Correlations between plasma levels, clinical parameters, and outcomes (OS and DFS) were overall analyzed. High OPN (≥149.97 ng/mL), MMP7 (≥2.28 ng/mL), and PSG9 (≥45.59 ng/mL) were prognostic indicators of reduced OS ( <0.001, <0.001, and =0.007, respectively). Plasma PSG9 protein level was an independent factor in predicting OS ( =0.008) and DFS ( =0.038). Plasma OPN+MMP7+PSG9 elevation in combination was a prognostic factor for OS ( <0.001). OPN was demonstrated to be a risk factor-associated OS in stage I patients with HCC and patients with low α-fetoprotein levels (<20 ng/mL). These findings suggested that OPN, MMP7, PSG9 and their combined panels may be useful for aiding in tumor recurrence and mortality risk prediction of patients with HCC, particularly in the early stage of HCC carcinogenesis.

关键词： biomarkers     OPN     MMP7     PSG9     HCC     prognosis    

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Towards the optimization of management of hepatocellular carcinoma

Xi Feng, Madhava Pai, Malkhaz Mizandari, Tinatin Chikovani, Duncan Spalding, Long Jiao, Nagy Habib

《医学前沿（英文）》 2011年 第5卷 第3期   页码 271-276 doi: 10.1007/s11684-011-0148-4

摘要： Hepatocellular carcinoma (HCC) is the fifth most common neoplasm in the world, closely correlated with viral hepatitis and liver cirrhosis. The vast majority of HCC patients present at a late stage and are unsuitable for surgery due to limited liver functional reserve. Tumors can involve major vessels or hilar structures, necessitating major liver resection and/or rendering liver resection unfeasible. A series of new technologies have been developed to optimise HCC management. Stem cell therapy improves impaired liver functional reserve prior to liver resection. Intravascular radiofrequency ablation recanalises the portal vein invaded by tumour thrombus and endobiliary radiofrequency ablation restores and extends biliary patency of the bile duct invaded by malignancy. Laparoscopic radiofrequency assisted liver resection minimizes blood loss and avoids liver warm ischemia, while increasing parenchymal sparing. These benefits combined maximize the safety of liver resection.

关键词： management     hepatocellular carcinoma (HCC)     radiofrequency (RF) ablation     laparoscopic liver resection     stem cell     intravascular RF ablation     endobiliary RF ablation    

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标题 作者 时间 类型 操作

Adjuvant treatment strategy after curative resection for hepatocellular carcinoma

Wei Zhang, Bixiang Zhang, Xiao-ping Chen

期刊论文

Prevention and treatment of pancreatic fistula after pancreatic body and tail resection: current status

Li Jiang, Deng Ning, Xiaoping Chen

期刊论文

loaded natural extracellular matrix hydrogel for inhibition of glioblastoma recurrence after tumor resection

期刊论文

Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors

null

期刊论文

Endoscopic resection of a huge Brunner's gland adenoma

ZHANG Binbin, REN Xu, TANG Xiufen, CHI Yuxin, SHI Xuesong

期刊论文

Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

GU Jin, YAO Yunfeng, LI Jiyou, LU Aiping, WANG Hongyi

期刊论文

Post-surgical resection prognostic value of combined OPN, MMP7, and PSG9 plasma biomarkers in hepatocellular

Weiqi Rong, Yang Zhang, Lei Yang, Lin Feng, Baojun Wei, Fan Wu, Liming Wang, Yanning Gao, Shujun Cheng, Jianxiong Wu, Ting Xiao

期刊论文

Towards the optimization of management of hepatocellular carcinoma

Xi Feng, Madhava Pai, Malkhaz Mizandari, Tinatin Chikovani, Duncan Spalding, Long Jiao, Nagy Habib

期刊论文