Patients with brain metastases are more prone to developing life-threatening neurological symptoms. Initial therapies include surgery, whole brain radiotherapy (WBRT), and stereotactic radiotherapy. With the progress of stereotactic radiotherapy, the indication of stereotactic radiosurgery (SRS) is gradually expanding, and the indications for surgery and WBRT gradually narrowed. The existing studies have shown that SRS can significantly benefit patients who are <50 years old with single brain metastasis, but the specific scope of the application with SRS is still controversial, and a large number of the phase Ⅲ randomized multicenter trials designed around the controversies are also developing. This review summarizes the results of clinical research and came to the conclusion. Firstly, postoperative adjuvant SRS in the treatment of brain metastases is superior to postoperative adjuvant WBRT. Secondly, using SRS in the elderly patients with multiple brain metastases are safe and effective. Thirdly, the use of targeted therapy in patients with brain metastases thereby delaying SRS may lead to poor prognosis. The focus of future research include selection of optimal timing for adjuvant targeted therapy after SRS and the appropriate patient population, as well as prevention of recurrence and metastasis after lacal treatment.
Objective
To explore risk factors of lymph node metastasis (LNM) in T1 rectal cancer.
Methods
The retrospective case-control study was conducted. The clinicopathologic data of 247 patients with T1 rectal cancer underwent radical resection were analyzed in the pathological database of the West China Hospital from January 2000 to December 2016, including the tumor size (maximum diameter), gross type, differentiation degree, histological type, lymph vascular infiltration, perineural infiltration, and carcinoma nodule. The univariate analysis and multivariate analysis were done using the Chi-square test and logistic regression model, respectively.
Results
The rate of LNM in the patients with T1 rectal cancer was 8.50% (21/247). No lymph metastasis was found in the well differentiated T1 rectal cancer. The results of the univariate analysis showed that the differentiation degree, histological type, and carcinoma nodule were related to the LNM in the T1 rectal cancer (P<0.050). The results of the multivariate analysis revealed that the poor differentiation, mucinous adenocarcinoma, signet-ring cell carcinoma, and carcinoma nodule were the independent risk factors of the LNM in the T1 rectal cancer (OR=9.75, P=0.006; OR=5.98, P=0.042; OR=8.33, P=0.017; OR=10.87, P=0.026).
Conclusion
In this large population dataset, poor differentiation, mucinous adenocarcinoma, signet-ring cell carcinoma, and carcinoma nodule are risk factors of LNM in T1 rectal cancer.
ObjectiveTo analyze the relative factors of lymph-nodes metastasis (LM) in patients with cervical cancer.
MethodsThe clinico-pathological data of 136 patients with stageⅠ A-Ⅱ A of cervical cancer who underwent surgical therapy from January 2005 to December 2010 were retrospectively analyzed. The correlation between clinico-pathological parameters and LM was analyzed by univariable χ2 analysis and multivariable logistic analysis.
ResultsThe total LM rate (LMR) was 14.0% (19/136). The rate of LM in obturator was the highest (63.2%), and then the rate between the external and internal iliac was 42.1%. The rate of deep inguinal lymph nodes and para-aortic lymph node was 0.0%. There was correlation between the clinic staging, depth of stromal invasion, histologic subtype, parametrial invasion, vaginal invasion and LM in univariable analysis (P<0.05). While in multivariable analysis, the correlation with LM was only existed between the clinic staging, histologic subtype, depth of stromal invasion and LM.
ConclusionClinic staging, histologic subtype, depth of stromal invasion are high risk factors of LM.
Objective To investigate the expression of cerb B2 and CathepsinD in gastric carcinoma and its correlation with the biological behavior of gastric carcinoma (GC). MethodsThe expression was studied by immunohistochemical technique. The expression of cerb B2 and CathepsinD were analyzed with their relation to histologic types, depth of invasion, growth pattern, lymph node metastasis and prognosis of gastric carcinoma. ResultsThirtynine of the 102 gastric carcinoma specimens (38.24%) were positive for cerb B2 and correlated with depth of invasion (P＜0.05) and lymph node metastasis (P＜0.05); eightythree of the 102 gastric carcinoma specimens (81.37%) were positive for CathepsinD and correlated with depth of invasion (P＜0.05), growth pattern (P＜0.05), lymph node metastasis (P＜0.05) and blood vessels cancer embolus (P＜0.05). Prognosis of patients with gastric carcinoma with positive expression of cerb B2 or CathepsinD was poor. The 5year survival rate was significantly lower in gastric carcinoma patients with positive expression of cerb B2 or CathepsinD. Conclusion cerb B2 and CathepsinD are highly related to growth, invasion, metastasis and prognosis of gastric carcinoma.
Lymph node metastasis is the main and frequent metastatic way of lung cancer, it is also the reason of postoperative carcinoma residue which results in relapse and metastasis. It is vital to clean mediastinal lymph nodes and hilar lymph nodes in lung cancer operation. However, the patterns of lymphadenectomy are not yet uniform. There are complete mediastinal lymph node dissection(CMLND), radical lymph node dissection(RLND), lymph node sampling(LS), systematic lymph node sampling(SS) and sentinel lymph node navigation(SLN). And with the development of minimal invasive surgery, the thoracoscopic lymphadenectomy gets mature day by day. It is very necessary to find a more standardized and perfect patten of lymphadenectomy. This paper reviews the clinical significance, the pattens and the extent of mediastinal lymph node dissection and hilar lymph node dissection, and also reviews the current status and prospect of thoracoscopic lymphadenectomy
【Abstract】ObjectiveTo investigate the molecular mechanism of peritoneal dissemination of gastric cancer. MethodsLiteratures in recent years about mechanisms of peritoneal metastasis in gastric cancer were reviewed and summarized.ResultsPeritoneal metastasis related to viability of cancer cells and peritoneal characteristics. Moreover, it is necessary that many adhesive moleculars, protein hydrolase, cell factors and vascular factors involved in peritoneal metastasis.ConclusionPeritoneal metastasis of gastric cancer was induced by multiple factors together.
Objective To review the recent studies on the suppressing function of breast cancer metastasis suppressor 1 (BRMS1) in breast cancer metastasis. Methods The recent literatures on the mechanisms of BRMS1 in the breast cancer that were published in and abroad were reviewed and summarized. Results BRMS1, similar to the other anti-metastasis genes, only suppresses the metastasis of breast cancer cells but has nothing to do with the growth of tumor. BRMS1 could suppress metastasis of tumor cells by reestablishing both the homospecific and the heterospecific gap junctional intercellular comminications (GJIC) and by altering the expressions of relevant metastasis genes in the breast cancer. Conclusion Further studies on BRMS1 may be helpful to understand the metastasis of breast cancer, which may provide a new way for the diagnosis and treatment of breast cancer.
ObjectiveTo investigate the clinicopathologic features of intracranial anaplastic solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) and diagnosis and treatment after liver metastasis.MethodThe clinicopathologic data of patients with intracranial anaplastic SFT/HPC who had metastasized to the liver and other organs after surgery were collected from 2003 to 2019 in the Second Hospital of Lanzhou University.ResultsAll 3 patients with intracranial anaplastic SFT/HPC underwent surgical resection and supplemented with conventional radiotherapy after operation. After the initial intervention treatment, 2 patients relapsed at 10 years and 7 years after the operation, and 3 patients had liver metastases at 11, 7, and 6 years after the initial intervention treatment. One of them was accompanied by uterus, lung, and vertebral body metastases.ConclusionsIntracranial anaplastic SFT/HPC has a high risk of recurrence and extracranial metastasis. Liver is a common target organ for metastasis of anaplastic SFT/HPC, liver metastasis is delayed after initial intervention of intracranial anaplastic SFT/HPC, it requires a long-term close follow-up.
Children with retinoblastoma (RB) typically survive their cancer due to advances in early diagnosis and treatment. Extraocular invasion and metastasis, and secondary malignant tumor carry a very high mortality rate. Prerequisites for metastasis include tumor initiating capacity, altered cellular adhesion and cell motility, resistance to extracellular death signals and disruption of the basement membrane and extracellular matrix. All those changes can be determined by the cell of origin and the genetic instability of the tumor, responding to the multiple layers of pressure such as hypoxia, from the tumor microenvironment or niche. The interaction between tumor cells and the tumor stroma is regulated by several metastasissuppressor proteins and microRNA. This knowledge has important implications for our understanding and the treatment of extraocular spreading of RB.
ObjectiveTo study on the first metastasis pattern and prognostic factors in patients with recurrent and metastatic breast cancer.MethodsThe study selected 147 patients with metastatic breast cancer who were diagnosed for the first time in the Breast Thyroid Center and Oncology Department, the People's Hospital of Wuhan University from June 2016 to June 2018. The model of first metastasis and the first diagnosis of prognosis may be affected. The age at diagnosis of breast cancer, tumor size, lymph node metastasis, hormone receptor status, HER-2 status, number of metastatic organs, tumor location, molecular typing, etc. were retrospective analyzedResultsThe most common metastatic sites for breast cancer was bone metastases in 55 patients (37.41%), followed by lung metastasis and liver metastases, 29 (19.73%) and 24 (16.33%), respectively. Univariate analysis showed that the number of lymph node metastasis, HER-2 status, organ number of first-time metastasis, and endocrine therapy were significant factors affecting metastatic survival time, and the difference was statistically significant (P<0.05). Multivariate analysis showed that the number of lymph node metastasis, the number of metastatic organs and HER-2 were independent risk factors for advanced breast cancer (P<0.05).ConclusionsThe most common metastasis of breast cancer patients after surgery is bone, followed by lung metastasis and liver metastasis. The number of lymph node metastases, the number of metastatic organs, HER-2 status, and endocrine therapy are independent factors influencing the prognosis of patients with recurrent metastasis.
