共查询到20条相似文献,搜索用时 156 毫秒
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目的 回顾分析T3N0~1M0期鼻咽癌患者临床资料,探讨单纯放射治疗与同期放化疗两种治疗方式与预后的关系。方法 中山大学肿瘤防治中心2004年1月至12月收治的经病理学证实的初治鼻咽癌患者781例,均有完整鼻咽和颈部MRI资料,且均无远处转移。按照2008中国鼻咽癌分期标准重新分期,82例行单纯放疗或同期放化疗的T3N0~1M0期患者入组,分为单纯放疗(A组)46例,同时期放化疗(B组)36例。结果 两组患者的临床资料具有可比性,单因素分析显示A组和B组的5年总生存(OS)率分别为93.5 %和100 %(P=0.046),5年无瘤生存(DFS)率分别为85.2 %和91.7 %(P=0.498)。N分期是鼻咽癌DFS的影响因素(P=0.026)。分层分析显示:T3N0M0期患者A组和B组5年OS率分别为94.7 %和100 %(P=0.432);T3N1M0期A组和B组5年OS率分别为92.6 %和100 %(P=0.066);T3N1M0期A组和B组5年DFS率分别为73.7 %和89.3 %(P=0.244)。多因素分析显示,同期放化疗不是 T3N0~1M0期鼻咽癌患者OS的独立预后因素(HR=0.019;95 % CI 0~21.793),N分期不是影响T3N0~1M0期鼻咽癌患者DFS的独立预后因素(HR=0.203;95 % CI 0.135~1.231×104)。结论 T3N0M0期患者同期放化疗与单纯放疗疗效无差异, T3N1M0期患者行同期放化疗能否改善生存有待进一步研究。 相似文献
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《中国肿瘤临床与康复》2020,(2)
目的探讨放疗前外周血中性粒细胞和淋巴细胞比值(NLR)与鼻咽癌预后的相关性。方法选取2005年1月至2013年3月间南京医科大学第二附属医院收治的105例新发鼻咽癌患者,分析NLR对鼻咽癌总生存时间(OS)的影响及NLR与年龄、性别和TNM分期的关系。结果患者外周血NLR平均值为(2. 82±0. 24),NLR与鼻咽癌患者T分期、N分期和M分期有关,其中T3+T4、N2+N3和M1期患者,NLR明显高于T1+T2、N0+N1和M0期(均P <0. 05),说明分期越晚,NLR越高。NLR与性别和年龄无关(P> 0. 05)。NLR、T分期、N分期和M分期与鼻咽癌的预后均呈负相关。即NLR>3、TNM分期越晚,患者OS越短(均P <0. 05)。NLR和TNM分期是影响鼻咽癌患者预后的独立危险因素(P <0. 05)。结论治疗前NLR升高是影响鼻咽癌预后的不良因素,为预测鼻咽癌的预后提供了新方法。 相似文献
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目的 通过与术后病理分期标准的比较,探讨《非手术治疗食管癌的临床分期标准(草案)》的分布合理性及判断预后的价值。方法 回顾分析2009—2012年间本院根治手术或术后辅助治疗的 162例食管癌患者临床资料,对其进行术前临床分期及术后病理分期,并采用Kappa法分析两种分期间各期病例分布一致性。Kaplan-Meier法计算OS率并Logrank法检验差异和单因素分析。结果 T、N、TNM分期总符合率分别为67.9%、57.4%、67.9%,一致性程度分别为中等、较差、中等(Kappa=0.544、0.302、0.509)。随访率为93.2%,1、2、3年样本数分别为127、66、27例。全组1、2、3年OS率分别为82.6%、56.2%、37.7%。术前除了T1与T2期、N0与N1期OS相近外(P=0.086、0.101),T、N、TNM分期各期间OS均不同(P=0.000~0.028),与术后病理分期对预后判断的预示作用一致。结论 《非手术治疗食管癌的临床分期标准(草案)》的分布合理性一般,预后判断价值较好,但仍需进一步细化和完善。 相似文献
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目的:回顾性配对分析以适形调强放疗为基础的不同治疗模式对非高发区T1~2N1M0期鼻咽癌患者预后的影响。方法:回顾性分析2010年1月至2015年12月河南省肿瘤医院初治的行根治性放疗的T1~2N1M0期鼻咽癌患者,筛选出51对患者(单纯放疗组和同期放化疗组各51例)进行配对分析。比较两组患者各项生存率及急性不良反应。结果:全组5年总生存率、无局部复发生存率、无区域复发生存率、无远处转移生存率分别为94.1%、93.6%、96.7%、90.9%。单纯放疗组与同期放化疗组相比,5年总生存率(95.9%vs. 92.2%,P=0.894)、无局部复发生存率(94.1%vs. 93.3%,P=0.976)、无区域复发生存率(95.8%vs. 97.6%,P=0.572)、无远处转移生存率(91.4%vs. 90.2%,P=0.716),差异均无统计学意义。急性不良反应方面,与单纯放疗组相比,同期放化疗组呕吐、中性粒细胞减少、白细胞减少、血红蛋白减少和黏膜炎的发生率显著升高。结论:对于T1~2N1M0期鼻咽癌患者,同期化疗的加入并未明显改善患者预后,且急性不良反应增加。 相似文献
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目的:探讨术前营养风险对膀胱癌根治术患者预后的影响。方法:回顾性分析2010年02月至2018年05月我院泌尿外科收治的186例行根治性全膀胱切除术患者的临床资料。术前采用营养风险评估表(NRS-2002)筛查患者营养风险,根据NRS-2002评分结果将患者分为有营养风险组(总评分≥3分)96例和无营养风险组(总评分<3分)90例。比较两组患者临床资料;采用Kaplan-Meier模型对两组患者的肿瘤无复发生存期(recurrence free survival,RFS)和总生存期(overall survival,OS)进行分析;患者RFS和OS的独立危险因素采用多因素Cox比例风险回归模型分析。结果:有营养风险组和无营养风险组在病理T分期、肿瘤大小、是否淋巴结转移、肾积水方面比较差异有统计学意义(P<0.05);有营养风险组和无营养风组险5年RFS率分别为29.17%(28/96)、45.56%(41/90),5年OS率分别为43.75%(42/96)、58.89%(53/90);Kaplan-Meier分析结果显示,有营养风险组患者的RFS和OS均短于无营养风险组(P<0.05);Cox比例风险回归模型显示,术前营养风险是影响膀胱癌根治术患者RFS和OS的独立危险因素(P<0.05)。结论:术前有营养风险是膀胱癌根治术患者RFS和OS的独立危险因素,有营养风险的患者术后预后更差。 相似文献
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Victor Ho-Fun Lee Dora Lai-Wan Kwong To-Wai Leung Cheuk-Wai Choi Brian O'Sullivan Ka-On Lam Vincent Lai Pek-Lan Khong Sik-Kwan Chan Chor-Yi Ng Chi-Chung Tong Patty Pui-Ying Ho Wing-Lok Chan Lai-San Wong Dennis Kwok-Chuen Leung Sum-Yin Chan Tsz-Him So Mai-Yee Luk Anne Wing-Mui Lee 《International journal of cancer. Journal international du cancer》2019,144(7):1713-1722
The eighth edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) stage classification (TNM) for nasopharyngeal carcinoma (NPC) was launched. It remains unknown if incorporation of nonanatomic factors into the stage classification would better predict survival. We prospectively recruited 518 patients with nonmetastatic NPC treated with radical intensity-modulated radiation therapy ± chemotherapy based on the eighth edition TNM. Recursive partitioning analysis (RPA) incorporating pretreatment plasma Epstein–Barr virus (EBV) DNA derived new stage groups. Multivariable analyses to calculate adjusted hazard ratios (AHRs) derived another set of stage groups. Five-year progression-free survival (PFS), overall survival (OS) and cancer-specific survival (CSS) were: Stage I (PFS 100%, OS 90%, CSS 100%), II (PFS 88%, OS 84%, CSS 95%), III (PFS 84%, OS 84%, CSS 90%) and IVA (PFS 71%, OS 75%, CSS 80%) (p < 0.001, p = 0.066 and p = 0.002, respectively). RPA derived four new stages: RPA-I (T1–T4 N0–N2 & EBV DNA <500 copies per mL; PFS 94%, OS 89%, CSS 96%), RPA-II (T1–T4 N0–N2 & EBV DNA ≥500 copies per mL; PFS 80%, OS 83%, CSS 89%), RPA-III (T1–T2 N3; PFS 64%, OS 83%, CSS 83%) and RPA-IVA (T3–T4 N3; PFS 63%, OS 60% and CSS 68%) (all with p < 0.001). AHR using covariate adjustment also yielded a valid classification (I: T1–T2 N0–N2; II: T3–T4 N0–N2 or T1–T2 N3 and III: T3–T4 N3) (all with p < 0.001). However, RPA stages better predicted survival for PS and CSS after bootstrapping replications. Our RPA-based stage groups revealed better survival prediction compared to the eighth edition TNM and the AHR stage groups. 相似文献
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Kamat AM Dinney CP Gee JR Grossman HB Siefker-Radtke AO Tamboli P Detry MA Robinson TL Pisters LL 《Cancer》2007,110(1):62-67
BACKGROUND: Micropapillary bladder carcinoma is a rare variant of urothelial carcinoma. To improve understanding of this disease, the authors performed a retrospective review of their experience. METHODS: The authors reviewed the records of 100 consecutive patients with micropapillary bladder cancer who were evaluated at The University of Texas M. D. Anderson Cancer Center. RESULTS: The mean age of the patients was 64.7 years, with a male:female ratio of 10:1. The TNM stage of disease at the time of presentation was Ta in 5 patients, carcinoma in situ (CIS) in 4 patients, T1 in 35 patients, T2 in 26 patients, T3 in 7 patients, T4 in 6 patients; N+ in 9 patients, and M+ in 8 patients. Kaplan-Meier estimates of 5-year and 10-year overall survival (OS) rates were 51% and 24%, respectively. Bladder-sparing therapy with intravesical bacillus Calmette-Guerin therapy was attempted in 27 of 44 patients with nonmuscle-invasive disease; 67% (18 patients) developed disease progression (>or=cT2), including 22% who developed metastatic disease. Of 55 patients undergoing radical cystectomy for surgically resectable disease (相似文献
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目的 探讨非手术食管癌临床分期的有效性及预测预后的临床价值。方法 分析2003-2010年期间在本院行食管癌根治术,术前有EUS、食管镜、CT、食道造影等详细检查,术后有详细病理分期的358例患者资料。分析术前影像学分期与术后病理分期的预测值,分别按2002、2009年UICC病理分期及临床分期,分析患者无瘤生存及总生存。 结果 全组中位随访时间47个月,随访率为97.2%。有EUS+CT检查并能进行有效分期的305例(85.2%)。在305例中临床T分期对病理T分期的预测值为0~88.6%,其中T1期最高(88.6%)、T4期最低;临床N分期(N0、N1期)的预测值为62.5%~100%。虽然2002、2009年的分期间总生存率及无瘤生存率差异均有统计学意义(P=0.000、0.000),但2002年的分期内总生存除Ⅳ期只有2例与各期别相似外差异均有统计学意义,2009年的分期内总生存各期别差异无统计学意义。按2002年UICC TNM分期标准对305例进行EUS+CT临床分期的总生存及无瘤生存均有差异统计学意义(P=0.000、0.000)。 结论 影像学检查不能有效、准确提供淋巴结转移个数,但对淋巴结定性的预测值较高。EUS+CT的临床分期能有效预测非手术食管癌的预后。 相似文献
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Takahashi A Tsukamoto T Tobisu K Shinohara N Sato K Tomita Y Komatsubara S Nishizawa O Igarashi T Fujimoto H Nakazawa H Komatsu H Sugimura Y Ono Y Kuroda M Ogawa O Hirao Y Hayashi T Tsushima T Kakehi Y Arai Y Ueda S Nakagawa M 《Japanese journal of clinical oncology》2004,34(1):14-19
BACKGROUND: We report the outcome of radical cystectomy for patients with invasive bladder cancer, who did not have regional lymph node or distant metastases, at 21 hospitals. METHODS: Retrospective, non-randomized, multi-institutional pooled data were analyzed to evaluate outcomes of patients who received radical cystectomy. Between 1991 and 1995, 518 patients with invasive bladder cancer were treated with radical cystectomy at 21 hospitals. Of these, 250 patients (48.3%) received some type of neoadjuvant and/or adjuvant therapy depending on the treatment policy of each hospital. RESULTS: The median follow-up period was 4.4 years, ranging from 0.1 to 11.4 years. The 5-year overall survival rate was 58% for all 518 patients. The 5-year overall survival rates for patients with clinical T2N0M0, T3N0M0 and T4N0M0 were 67%, 52% and 38%, respectively. The patients with pT1 or lower stage, pT2, pT3 and pT4 disease without lymph node metastasis had 5-year overall survivals of 81%, 74%, 47% and 38%, respectively. The patients who were node positive had the worst prognosis, with a 30% overall survival rate at 5 years. Neoadjuvant or adjuvant chemotherapy did not provide a significant survival advantage, although adjuvant chemotherapy improved the 5-year overall survival in patients with pathologically proven lymph node metastasis. CONCLUSIONS: The current retrospective study showed that radical cystectomy provided an overall survival equivalent to studies reported previously, but surgery alone had no more potential to prolong survival of patients with invasive cancer. Therefore, a large-scale randomized study on adjuvant treatment as well as development of new strategies will be needed to improve the outcome for patients with invasive bladder cancer. 相似文献
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Leonard L. Gunderson MD MS Matthew Callister MD Robert Marschke MD Tonia Young-Fadok MD Jacques Heppell MD Jonathan Efron MD 《Current colorectal cancer reports》2006,2(3):151-159
In rectal cancer pooled analyses of phase III North American trials, both overall survival (OS) and disease-free survival
(DFS) were dependent on TN stage, NT stage, and treatment method. Three risk groups of patients were defined: intermediate
(T1-2N1, T3N0), moderately high (T1-2N2, T3N1, T4N0), and high (T3N2, T4N1, T4N2). Patients with a single high-risk factor
(T1-2N1, T3N0) have better OS, DFS, and disease control than patients with both high-risk factors. Within TNM stage II rectal
cancer, different treatment strategies are indicated for stage IIA (T3N0) versus stage IIB (T4N0) patients based on differential
rates of survival and disease relapse. Use of trimodality treatment (surgery plus radiation and chemotherapy; S+RT+CT) for
all T3N0 patients may be excessive, as S+CT resulted in 5-year OS of approximately 85% in the second rectal cancer pooled
analysis; however 5-year DFS with S+CT was 69% indicating room for improvement. Stage IIB patients are preferably treated
with preoperative chemoradiation, but stage IIA patients could appropriately be treated with either preoperative or postoperative
chemoradiation. 相似文献
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PurposeThis study evaluated the prognostic value of preoperative locoregional staging in patients with colon cancer and who underwent curative resection.MethodsA total of 536 consecutive patients who underwent curative resection for colon cancer from February 1999 to November 2007 were prospectively enrolled. The clinicopathological variables, including the radiological staging using computed tomography, were analyzed for the prognostic significance.ResultsThe 5-year overall survival rates of the patients with radiological T1, T2, T3, and T4 were 96%, 89%, 75%, and 79%, respectively (P = 0.028). The 5-year overall survival rates were 83%, 76%, and 54%, respectively, for patients with radiological N0, N1, and N2 disease (P < 0.001). The 5-year overall survival rates of the patients with radiological TNM (tumor–node–metastasis) stages I, II, and III were 90%, 81%, and 70%, respectively (P < 0.001) and the 5-year overall survival rates of the patients with pathological TNM stages I, II, and III were 93%, 80%, and 70%, respectively (P = 0.001). On multivariate analysis, the radiological T and N categories remained independent prognostic factors for both overall survival and disease-free survival.ConclusionRadiological staging is an independent predictor of long-term survival in the preoperative setting. 相似文献
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《Clinical genitourinary cancer》2014,12(5):e233-e240
BackgroundDespite aggressive local therapy, patients with locally advanced bladder cancer have a significant risk of distant metastases. This study evaluated the role of neoadjuvant combination chemotherapy with gemcitabine/cisplatin (GC) in improving the outcome of this group of patients over radical cystectomy alone.Patients and MethodsA total of 114 patients with newly diagnosed bladder cancer (T3-4, N0-2, M0) were randomized to radical cystectomy alone or initial 3 cycles of GC, then managed according to response. Patients who achieved complete response completed 6 cycles of GC followed by local radiation therapy (RT) only. If tumors were downstaged to T1, complete transurethral resection was done, followed by 3 cycles of GC and then RT. Patients with partial response underwent radical cystectomy followed by 3 cycles of GC. Patients with stable disease or disease progression underwent radical cystectomy.ResultsThe overall response rate to GC was 55.1%, and complete response was achieved in 28.6%. The 3-year overall survival (OS) was 51.9% versus 51.2% in the chemotherapy and surgery arms, respectively (P = .399). The 3-year disease-free survival was 31.8% in the chemotherapy arm and 45.1% in the surgery arm (P = .06). Bladder preservation was achieved in 22.5% of patients in the neoadjuvant arm. OS was 78% in responding patients and 100% in patients with complete response.ConclusionNeoadjuvant GC did not improve survival in locally advanced bladder cancer over radical cystectomy alone. However, bladder preservation was feasible, and OS in responding patients was impressive. Therefore, predictive models to select patients are needed. This is the largest prospective study of squamous cell carcinoma and transitional cell carcinoma using neoadjuvant GC. 相似文献