简介：AsreadersofCancerBiologyandMedicinewellknow,therehasbeenaseismicshiftinhumanmolecularbiologyoverthepastfewyears,asmomentousinitsownwayasthediscoveryofthedouble-helicalstructureofDNAbyWatsonandCrick60yearsago,theelucidationofthegeneticcodeshortlythereafter,theadventofrecombinantDNAandgenecloning

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简介：Earlydiagnosisandtreatmentisthekeytoimprovingtheprognosisofgastriccancer.Thepastdecadeshavewitnessedtherapidadvancesinthediagnosisandmanagementofearlygastriccancer(EGC):endoscopyhasplayedanincreasinglyimportantrole,whereaslaparoscopictechniqueshavealsobeenintroducedforEGCtreatment.InChina,the

简介：Thecombinationofradiotherapy(RT)andfunction-preservingsurgeryisthemostusualcontemporaryapproachinthemanagementofsofttissuesarcomas(STS).Pre-andpostoperativeRTresultinsimilarlocalcontrolrates,asshownbyalandmarktrialinextremitySTS.Inthisreview,theroleofRTinthemanagementofextremitySTSwillbediscussed,butSTSinothersites,includingretroperitonealSTS,willalsobeaddressed.ThefocuswillconsidervariousaspectsofRTincludingstrategiestoreducethevolumeoftissuebeingirradiated,dose,scheduling,andthepossibleofomissionofRTinselectedcases.Finally,technologyadvancesthroughtheuseofintensity-modulatedradiotherapy(IMRT),image-guidedIMRT,intraoperativeradiotherapy(IORT)andparticletherapywillalsobediscussed.

简介：Themyelodysplastic/myeloproliferativeneoplasms(MDS/MPNs)areauniquegroupofhematologicmalignanciescharacterizedbyconcomitantmyelodysplasticandmyeloproliferativefeatures.Accordingtothe2008WHOclassification,thecategoryincludesatypicalchronicmyeloidleukemia(aCML),chronicmyelomonocyticleukemia(CMML),juvenilemyelomonocyticleukemia(JMML),MDS/MPN-unclassifiable(MDS/MPN-U),andtheprovisionalentityrefractoryanemiawithringsideroblastsandthrombocytosis(RARS-T).Althoughdiagnosiscurrentlyremainsbasedonclinicopathologicfeatures,theincorporationofnextgenerationplatformshasallowedfortherecentmolecularcharacterizationofthesediseaseswhichhasrevealeduniqueandcomplexmutationalprofilesthatsupporttheirdistinctbiologyandisanticipatedtosoonplayanintegralroleindiagnosis,prognostication,andtreatment.Futuregoalsofresearchshouldincludethedevelopmentofdisease-modifyingtherapies,andfurthergeneticunderstandingofthecategorywilllikelyformthefoundationoftheseefforts.

简介：Braintumorsincidenceinpediatricagehasbeenestimatedbetween1.3to5%witharelativeincidenceof1.4to11%duringthefirstyearoflife;theimprovementininstrumentaldeviceshasleadtoarelativeincreaseinprecociousdiag-nosis.Thechoicetostudybraintumorsofthefirstyearoflifeasaseparatetopicfrompediatricageonesdependsontheobservationthatthesele-sionshavepeculiarclinical,topographicandtis-sularcharacteristics.Thesurvivalrateofthesepatientsisverypoorifcomparedwiththatfound

简介：Inordertofurtherpromotethestandardizationofdiagnosisandtreatmentofgastrointestinalstromaltumor(GIST)inChina,themembersofChineseSocietyofClinicalOncology(CSCO)ExpertCommitteeonGISTthoroughlydiscussedthekeycontentsoftheconsensusguidelines,andvotedonthecontroversialissue.Infinal,theChineseconsensusguidelinesforthediagnosisandmanagementofGIST(2017edition)wasformedonthebasisof2013editionconsensusguidelines,whichisherebyannounced.Theconsensusincludedthepathologicaldiagnosis,recurrenceriskclassificationevaluation,targetedagenttherapy,surgeryandprinciplesofsurveillanceofGIST.

简介：OBJECT:Optimummanagementforelderlypatientswithnewlydiagnosedglioblastoma(GBM)inthetemozolomide(TMZ)eraisnotwelldefined.Theobjectofthisstudywastoclarifyoutcomesinthispopulation.METHODS:Theauthorsretrospectivelyreviewed105consecutivecasesinvolvingelderlypatients(age≥65years)withnewlydiagnosedGBMwhoweretreatedattheMayoClinicbetween2003and2008.RESULTS:Thepatients'medianagewas74years(range66-87years),andthemedianKarnofskyPerformanceStatus(KPS)scorewas80(range40-90).Halfofthepatientsunderwentbiopsyandhalfunderwentresection.Patientswithdeep-seatedlesions(19patients[18%])ormultifocallesions(34patients[32%])weremorelikelytohavebiopsythanresection(p=0.0001and0.0009,respectively).Newpersistentneurologicaldeficitsdevelopedin7patients(6.7%).Postoperativehemorrhageoccurredin6patients(5.7%),allofwhomunderwentbiopsy.Completefollow-updataregardingadjuvanttreatmentwasavailablein84patients.Forty-one(49%)weretreatedwithchemotherapy(mostlyTMZ)andradiationtherapy(RT),and23(27%)withRTalone.Nineteen(23%)receivedonlypalliativecareaftersurgery(morecommonwithbiopsy,p=0.03).Chemotherapycomplicationsoccurredin28.6%(Grade3or4hematologicalcomplicationsin11.9%).Themedianvaluesforprogression-freesurvival(PFS)andoverallsurvival(OS)were3.5and5.5months.Inamultivariateanalysis,youngerage(p=0.03,riskratio[RR]0.34,95%CI0.13-0.89),singlelesion(p=0.02,RR0.51,95%CI0.30-0.89),resection(p=0.04,RR0.54,95%CI0.31-0.94),andadjuvanttreatment(p=0.0001,RR0.24,95%CI0.11-0.49)wereassociatedwithbetterOS.OnlyadjuvanttreatmentwassignificantlyassociatedwithprolongedPFS(p=0.0007,RR0.27,95%CI0.13-0.57).Withcombinedtherapywithresection,RT,andchemotherapy,themedianPFSandOSwere8and12.5months,respectively.CONCLUSIONS:TheprognosisforGBMworsenswithincreasingageinelderlypatients.Withimportantrisks,resectionandadjuvanttreatmen

简介：BACKGROUND&OBJECTIVE:Themajorityofintramedullaryspinalcordtumors(IMSCT)arelow-gradegliomas.RadicalresectionforIMSCTsremainschallenging.Recently,improvedneuroimagingandadvancedmicrosurgicaltechniquehavemadegreatsuccessinsurgicalmanagementoftheintramedullaryspinalcordtumors.METH-ODS&RESULTS:Twenty-ninepatientswithintramedullaryspinalcordtumorsweretreatedbyradicalresectiondur-ingthepast4yearsinourinstitute.Thehistologicalresultswereasfollows:12ependymomas,4astrocytomas,4heman-gioblastomas,4epidermoids,1cavernoma,2lipomas,2metastatics.Agross-totalresection(>95%)wasachievedin25surgicalprocedures.Subtotalresections(80-95%)wereperformedin4cases.Therewasnosurgicaldeath.Whencomparingthepreoperativeand3-monthpostoperativefunctionalgrades,12patientswerestable14improved,and3deteriorated.Patientswitheithernodeficitoronlymilddeficitbeforesurgerywererarelyimpairedbytheproce-dure,reinforcingtheimportanceofearlydiagnosisandtreatment.Themajordeterminantoflong-termsurvivalwashistologi-calcompositionofthetumor.PatientsinwhomanIMSCTwasonlypartiallyresected(<80%)faredsignificantlyworse.CONCLUSIONS:Thelong-termsurvivalandqualityoflifeforpatientswithlow-gradegliomastreatedbyradi-calresectionaloneiscomparableorsuperiortominimalresectionplusradiotherapy.Theoptimaltherapyforpatientswithhigh-gradegliomaisyettobedetermined.Forbenignlesion,suchashemangioblastomaandcavernomacouldbecuredbytotalresectionofthetumor.Forlipomaandepidermoid,fibrousadhesionstothecordmaketotalremovaldifficult,andthus,removalisnotthegoalofsurgery.Thecarbondioxidelaserisparticularlyusefulduringsurgeryforthislesion.

简介：Advancedgastriccancer(GC)hasbeenrecognizedaslethaldiseasewhenperitonealmetastases(PM)occurred.ThereisnostandardtreatmentforadvancedGCwithPM.Until1980s,thetherapeuticarenaforthesepatientshadremainedstagnant,withnotherapeuticapproachhavingshownasurvivalgaininGCwithPM.However,cytoreductivesurgery(CRS)withperitonectomyproceduresandintraperitonealchemotherapy(IPC)promisingnewcombinedtherapeuticapproachtoachievediseasecontrolforGCwithPM.TherecentpublicationschangedtheGCwithPMtreatmentlandscapebyprovidinganevidencethatCRSandIPCledtoprolongationinoverallsurvival(OS).ThisreviewwillprovideanoverviewoftheevolvingroleofCRSandIPCinthemanagementofadvancedGCwithPMinthecurrentera.

简介：Non-parasitichepaticcystswithbiliarycommunicationarerare.Theclinicalsymptomsinvolvedarenotspecifictothiscondition,therebymakingdiagnosisdifficultandtreatmentcontroversial.Here,wereportacaseof70-year-oldwomancomplainingofabdominalsatiety,combinedwithnon-specificpainintherightupperquadrant.Theabdominalcontrast-enhancedMRI-scanrevealedalargeandthick-walledseptuscysticlesionintheliver.Duringoperation,thebiliaryfistulawasconfirmedinthecystcavity.Asilicageltubewasinsertedviathecysticductforcholangiography,whichdemonstratedcommunicationbetweenthecystandbiliarytract.Weperformedwide-scalecystwallresection;thebiliaryfistulawascompletelyrepairedbytheclosureofcommunicatedbileducts.Thepostoperativecoursewasuneventful,andthepatientwasdischargedwithnosignofcholangitisoranyothersymptoms.Thenovelsurgicalmanagementviawideresectionofthecystwallandclosureofbiliarycommunicationprovedtobeanadequateandeffectiveprocedurefortreatingnonparasitichepaticcystswithbiliarycommunication.

简介：Neurochirurgie,2008Jun21.INTRODUCTION:Neoangiogenesisisacriticalfeaturethatcandifferentiatehigh-gradefromlow-gradeglioma.Conven-tionalMRimagingdoesnotassessthishistologicalfeatureaccurately.Thegoalofthisstudywastoevaluatethegaininrel-ativecerebralbloodvolumemeasurementusingperfusionMRIinthemanagementofcerebralgliomas.MATERIALSAND

简介：Primarycentralnervoussystemlymphoma(PCNSL)isararedisorderthat,in95%ofcases,representsdiffuselargeB-celllymphoma.Assuch,makinganaccuratediagnosisisimportant.Atpresent,stereotactic-guidedbiopsyisarecognizedmethodofchoicefortissueanalysis.However,thediagnosticwork-upforhigh-riskpatientsisdeterminedbytheirperformancestatus.Here,wereportacaseofPCNSLinahigh-riskpatient,forwhomdiagnosiswasestablishedbycerebrospinalfluidcytologyandflowcytometry,whichsignificantlyshortenedadiagnosticwork-upperiodandallowedfortheimmediatetreatmentofthepatient.

简介：Objective:Europeanlungcancerscreeningstudiesusingcomputedtomography(CT)haveshownthatamanagementprotocolbasedonmeasuringlungnodulevolumeandvolumedoublingtime(VDT)ismorespecificforearlylungcancerdetectionthanadiameter-basedprotocol.However,whetherthisalsoappliestoaChinesepopulationisunclear.Theaimofthisstudyistocomparethediagnosticperformanceofavolume-basedprotocolwithadiameter-basedprotocolforlungcancerdetectionandoptimizethenodulemanagementcriteriaforaChinesepopulation.Methods:Thisstudyhasapopulation-based,prospectivecohortdesignandincludes4000participantsfromtheHexidistrictofTianjin,China.Participantswillundergolow-dosechestCTatbaselineandafter1year.Initially,detectedlungnoduleswillbeevaluatedfordiameterandmanagedaccordingtoaroutinediameter-basedprotocol(ClinicalPracticeGuidelineinOncologyforLungCancerScreening,Version2.2018).Subsequently,lungnoduleswillbeevaluatedforvolumeandmanagementwillbesimulatedaccordingtoavolume-basedprotocolandVDT(aEuropeanlungnodulemanagementprotocol).Participantswillbefollowedupfor4yearstoevaluatelungcancerincidenceandmortality.TheprimaryoutcomeisthediagnosticperformanceoftheEuropeanvolume-basedprotocolcomparedtodiameter-basedmanagementregardinglungnodulesdetectedusinglow-doseCT.Results:Thediagnosticperformanceofvolume-anddiameter-basedmanagementforlungnodulesinaChinesepopulationwillbeestimatedandcompared.Conclusions:Throughthestudy,weexpecttoimprovethemanagementoflungnodulesandearlydetectionoflungcancerinChinesepopulations.

简介：Circulatingfreenucleicacids;cellfreeDNAandcirculatingmicro-RNA,arefoundintheplasmaofpatientswithhematologicandsolidmalignanciesatlevelshigherthanthatofhealthyindividuals.InpatientswithhematologicmalignancycellfreeDNAreflectstheunderlyingtumormutationalprofile,whilstmicro-RNAsreflectgeneticinterferencemechanismswithinatumorandpotentiallythesurroundingmicroenvironmentandimmuneeffectorcells.Thesecirculatingnucleicacidsofferapotentiallysimple,non-invasive,repeatableanalysisthatcanaidindiagnosis,prognosisandtherapeuticdecisionsincancertreatment.

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