简介：AbstractSquamous cell carcinoma of the oral cavity and oropharynx have been used synonymously and interchangeably in the world literature in the context of head and neck cancers. As the 21st century progresses, divergence between the two have become more evident, particularly due to evidence related to human papillomavirus-associated oropharyngeal squamous cell carcinoma. As such, the American Joint Committee on Cancer recently published the 8th edition Cancer Staging Manual, serving as a continued global resource to clinicians and researchers. Through changes in staging related to T and N clinical and pathologic classifications, the new system is expected to influence current management guidelines of these cancers that have distinct anatomic and etiopathogenic characteristics. This article aims to review such impactful changes in a time of critical transition of the staging of head and neck cancer and how these changes may affect clinicians and researchers worldwide.

简介：以便分类机警地位，脑电图(EEG)的19条隧道从5个题目的信号在白天小睡期间被获得。特征(包括的时间域特征，频率域特征和非线性的特征)的十种不同类型从EEG信号被提取，并且一个改进自我组织的地图(ISOM)神经原网络被建议它成功地识别这些题目的三不同大脑地位：了解，睡意和睡觉。与传统的SOM相比，实验结果证明ISOM产生好一些的分类精确性，象89.59%一样高到达。

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简介：AbstractIntroduction:Rosai-Dorfman disease (RDD) is an uncommon, benign, and idiopathic histiocytic proliferative disorder. Multiple intracranial RDD is extremely rare and treatment varies.Case presentation:A 9-year-old girl was admitted with 3-month history of blurred vision and facial paralysis, a 2-month history of recurrent giggle, and cognitive impairment. Computed tomography and magnetic resonance imaging scans revealed bilateral ventricular masses based on the dural membrane and the diameters of the masses were 9.1 cm and 9.2 cm, respectively. The lesions were completely removed with staging surgeries. Fifteen months after operation, blurred vision was still present but facial paralysis and giggle and cognitive impairment disappeared. Imaging examinations suggested that there were no new or recurring lesions.Conclusion:For multiple large intracranial masses, surgical treatment is necessary and staged surgery benefits perioperative safety. Active follow-up with magnetic resonance imaging is necessary.

简介：AIMTocomparesurvivalandrecurrenceinhepatocellularcarcinoma（HCC）patientswhodidordidnotreceiveadjuvanttransarterialchemoembolization（TACE）.METHODS：Aconsecutivesampleof229patientswhounderwentcurativeresectionbetweenMarch2007andMarch2010inourhospitalwasincluded.Ofthese229patients,91（39.7%）underwentcurativeresectionfollowedbyadjuvantTACEand138（60.3%）underwentcurativeresectionalone.Inordertominimizeconfoundsduetobaselinedifferencesbetweenthetwopatientgroups,comparisonswereconductedbetweenpropensityscore-matchedpatients.SurvivaldataandrecurrencerateswerecomparedusingtheKaplan-Meiermethod.IndependentpredictorsofoverallsurvivalandrecurrencewereidentifiedusingCoxproportionalhazardregression.RESULTS：Among61pairsofpropensityscorematchedpatients,the1-,2-,and3-yearoverallsurvivalrateswere95.1%,86.7%,and76.4%intheTACEgroupand86.9%,78.5%,and73.2%inthecontrolgroup,respectively.Atthesametime,theTACEandcontrolgroupsalsoshowedsimilarrecurrenceratesat1year（13.4%vs24.8%）,2years（30.6%vs32.1%）,and3years（40.1%vs34.0%）.MultivariateCoxregressionidentifiedserumalpha-fetoproteinlevel≥400ng/mLandtumorsize〉5cmasindependentriskfactorsofmortality（P〈0.05）.CONCLUSION：AspostoperativeadjuvantTACEdoesnotimproveoverallsurvivalorreducerecurrenceinHCCpatients,furtherstudyisneededtoclarifyitsclinicalbenefit.

简介：AIMToinvestigatetheimpactofsurgicalproceduresonprognosisofgallbladdercancerpatientsclassifiedwiththelatesttumor-node-metastasis（TNM）stagingsystem.METHODS：Aretrospectivestudywasperformedbyreviewing152patientswithprimarygallbladdercarcinomatreatedatPekingUnionMedicalCollegeHospitalfromJanuary2003toJune2013.Postsurgicalfollow-upwasperformedbytelephoneandoutpatientvisits.ClinicalrecordswerereviewedandpatientsweregroupedbasedontheneweditionofTNMstagingsystem（AJCC,seventhedition,2010）.Prognoseswereanalyzedandcomparedbasedonsurgicaloperationsincludingsimplecholecystectomy,radicalcholecystectomy（orextendedradicalcholecystectomy）,andpalliativesurgery.Simplecholecystectomyis,bydefinition,resectionofthegallbladderfossa.Radicalcholecystectomyinvolvesawedgeresectionofthegallbladderfossawith2cmnonneoplasticlivertissue;resectionofasuprapancreaticsegmentoftheextrahepaticbileductandextendedportallymphnodedissectionmayalsobeconsideredbasedonthepatient＇scircumstance.Palliativesurgeryreferstocholecystectomywithbiliarydrainage.DataanalysiswasperformedwithSPSS19.0software.Kaplan-MeiersurvivalanalysisandLogranktestwereusedforsurvivalratecomparison.P〈0.05wasconsideredRESULTS：Patientsweregroupedbasedonthenew7theditionofTNMstagingsystem,including8casesofstage0,10casesofstageⅠ,25casesofstageⅡ,21casesofstageⅢA,21casesofstageⅢB,24casesofstageⅣA,43casesofstageⅣB.Simplecholecystectomywasperformedon28cases,radicalcholecystectomyorexpandedgallbladderradicalresectionon57cases,andpalliativeresectionon28cases.Thirty-ninecaseswerenotoperated.Patientswithstages0andⅠdiseasedemonstratednostatisticalsignificantdifferenceinsurvivaltimebetweenthosereceivingradicalcholecystectomyandsimplecholecystectomy（P=0.826）.TheprognosisofstageⅡpatientswithradicalcholecystect

简介：SinceMurakamidefinedearlygastriccancer(EGC)asa'carcinomalimitedtothegastricmucosaand/orsubmucosaregardlessofthelymphnodestatus',severalauthorshavefocusedonthemostinfluentialhistopathologicalparametersforpredictingthedevelopmentoflymphnodemetastasesbyconsideringthelymphnodestatusasanimportantprognosticfactor.AfewauthorshavealsoconsideredthedepthofinvasionasoneofthekeystoexplainingtheexistenceofsubgroupsofpatientsaffectedbyEGCwithpoorprognoses.Inanycase,EGCisstillconsideredaninitialphaseoftumorprogressionwithgoodprognosis.Theintroductionofmodernendoscopicdeviceshasallowedaprecisediagnosisofearlylesions,whichcanleadtoimproveddefinitionsoftumorsthatcanberadicallytreatedwithendoscopicmucosalresectionorendoscopicsubmucosaldissection(ESD).Giventhewidespreaduseofthesetechniques,theJapaneseGastricCancerAssociation(JGCA)identifiedin2011thestandardcriteriathatshouldexcludethepresenceoflymphnodemetastases.Atthattime,EGCswithnodalinvolvementshouldhavebeenassertedasnolongerfittingthedefinitionofanearlytumor.Someauthorshavealsodemonstratedthatthemorphologicalgrowthpatternofatumor,accordingtoKodama'sclassification,isoneofthemostimportantprognosticfactors,therebysuggestingtheneedtoreportitinhistopathologicaldrafts.NotwithstandingtheacquiredknowledgeregardingtheclinicalbehaviorofEGC,Murakami'sdefinitionisstillbeingused.Thisdefinitionneedstobeupgradedaccordingtothemodernstagingofthediseasesothattheappropriatetreatmentwouldbeselected.

简介：Preoperativestagingoftheaxillainwomenwithinvasivebreastcancerusingultrasound-guidedneedlebiopsy(UNB)identifiesapproximately50%ofpatientswithaxillarynodalmetastasespriortosurgicalintervention.Althoughmoderatelysensitive,itisahighlyspecificstagingstrategythatisrarelyfalsely-positive,henceapositiveUNBallowspatientstobetriagedtoaxillarylymph-nodedissection(ALND)avoidingpotentiallyunnecessarysentinelnodebiopsy(SNB).Inthisreview,weextendourpreviousworkthroughanupdatedliteraturesearch,focusingonstudiesthatreportdataonUNButility.Basedondatafor10,934breastcancerpatients,sourcedfrom35studies,apositiveUNBallowedtriageof1,745cases(simpleproportion16%)toaxillarysurgicaltreatment:theutilityofUNBwasamedian19.8%[interquartilerange(IQR)11.6%-26.7%]acrossthesestudies.Wealsomodelleddatafromasubgroupofstudies,andestimatedthatamongstpatientswithmetastasestoaxillarynodes,theoddsratio(OR)forhighnodaldiseaseburdenforapositiveUNBversusanegativeUNBwas4.38[95%confidenceinterval(95%CI):3.13,6.13],P<0.001.Fromthismodel,theestimatedproportionwithhighnodaldiseaseburdenwas58.9%(95%CI:50.2%,67.0%)forapositiveUNB,whereastheestimatedproportionwithhighnodaldiseaseburdenwas24.6%(95%CI:17.7%,33.2%)ifUNBwasnegative.Overall,axillaryUNBhasgoodclinicalutilityandapositiveUNBcaneffectivelytriagetoALND.However,theevolvinglandscapeofaxillarysurgicaltreatmentmeansthatUNBwillhaverelativelylessutilitywheresurgeonshavemodifiedtheirpracticetoomissionofALNDforminimalnodalmetastaticdisease.

简介：ＴＨＥＲＯＬＥＯＦＭＲＩＩＮＴＨＥＩＬＬＵＳＴＲＡＴＩＯＮＯＦＭＥＴＡＳＴＡＴＩＣＬＹＭＰＨＡＴＩＣＰＡＴＨＷＡＹＳＡＮＤＣＬＩＮＩＣＡＬＮＳＴＡＧＩＮＧＯＦＮＡＳＯＰＨＡＲＹＮＧＥＡＬＣＡＲＣＩＮＯＭＡＷｅｉＸｉｏｎｇ韦雄ＬｉＪｉａｎｊｕｎ李建军...

简介：AbstractBackground:The classification criteria and staging groups for nasopharyngeal carcinoma described in the Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) staging system have been revised over time. This study assessed the proportion of patients whose staging and treatment strategy have changed due to revisions of the UICC/AJCC staging system over the past 10 years (ie, from the sixth edition to the eighth edition), to provide information for further refinement.Methods:We retrospectively reviewed 1901 patients with non-metastatic nasopharyngeal carcinoma treated in our cancer center between November 2009 and June 2012. The Akaike information criterion and Harrell concordance index were applied to evaluate the performance of the staging system.Results:In total, 25 (1.3%) of the 1901 patients who were staged as T2a according to the sixth edition system were downgraded to T1 in the eighth edition; 430 (22.6%) staged as N0 in the sixth edition were upgraded to N1 in the eighth edition; 106 (5.6%) staged as N1/2 in the sixth edition were upgraded to N3 in the eighth edition. In addition, 51 (2.7%) and 25 (1.3%) of the study population were upstaged from stage I to stage II and stage II to stage IVa, respectively; 10 (0.5%) was downgraded from stage II to stage I. The survival curves of adjacent N categories and staging groups defined by eighth classification system were well-separated. However, there was no significant difference in the locoregional failure-free survival (P = 0.730) and disease-free survival (P = 0.690) rates between the T2 and T3 categories in the eighth edition classification system.Conclusions:Modifications to the tumor-node-metastasis staging system over the past 10 years have resulted in N classification changes in numerous cases. Although the eighth edition tumor-node-metastasis staging system better predicts survival outcomes, the T classification could be simplified in future revisions.

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简介：Objective:TheUnionforInternationalCancerControl(UICC)Node(N)classificationisthemostcommonusedstagingmethodfortheprognosisofgastriccancer.Itdemandsadequate,atleast16lymphnodes(LNs)tobedissected;thereforedifferentstagingsystemswereinvented.Methods:BetweenMarch2005andMarch2010,164patientswereevaluatedattheDepartmentofGeneralSurgeryintheKenézyGyulaHospitalandattheDepartmentofGeneral,ThoracicandVascularSurgeryintheKaposiMórHospital.The6th,7thand8thUICCN-stagingsystems,thenumberofexaminedLNs,thenumberofharvestednegativeLNs,themetastaticlymphnoderatio(MLR)andthelogoddsofpositiveLNs(LODDS)weredeterminedtomeasuretheir5-yearsurvivalratesandtocomparethemtoeachother.Results:Theoverall5-yearsurvivalrateforallpatientswas55.5%withamedianoverallsurvivaltimeof102months.Thetumorstage,gender,UICCN-stages,MLRandtheLODDSweresignificantprognosticfactorsforthe5-yearsurvivalwithunivariateanalysis.The6thUICCN-stagedidnotfollowtheadequateriskincomparingN2vs.N0andN3vs.N0withmultivariateinvestigation.ComparisonofperformancesoftheresidualNclassificationsprovedthattheLODDSsystemwasfirstinthepredictionofprognosisduringtheevaluationofallpatientsandincaseswithlessthan16harvestedLNs.TheMLRgavethebestprognosticpredictionwhenadequate(morethanorequalto16)lymphadenectomywasperformed.Conclusions:WesuggesttheapplicationofLODDSsystemroutinelyinwesternpatientsandtheusageofMLRclassificationincaseswithextendedlymphadenectomy.

简介：AbstractBackground:Colorectal cancer is harmful to the patient’s life. The treatment of patients is determined by accurate preoperative staging. Magnetic resonance imaging (MRI) played an important role in the preoperative examination of patients with rectal cancer, and artificial intelligence (AI) in the learning of images made significant achievements in recent years. Introducing AI into MRI recognition, a stable platform for image recognition and judgment can be established in a short period. This study aimed to establish an automatic diagnostic platform for predicting preoperative T staging of rectal cancer through a deep neural network.Methods:A total of 183 rectal cancer patients’ data were collected retrospectively as research objects. Faster region-based convolutional neural networks (Faster R-CNN) were used to build the platform. And the platform was evaluated according to the receiver operating characteristic (ROC) curve.Results:An automatic diagnosis platform for T staging of rectal cancer was established through the study of MRI. The areas under the ROC curve (AUC) were 0.99 in the horizontal plane, 0.97 in the sagittal plane, and 0.98 in the coronal plane. In the horizontal plane, the AUC of T1 stage was 1, AUC of T2 stage was 1, AUC of T3 stage was 1, AUC of T4 stage was 1. In the coronal plane, AUC of T1 stage was 0.96, AUC of T2 stage was 0.97, AUC of T3 stage was 0.97, AUC of T4 stage was 0.97. In the sagittal plane, AUC of T1 stage was 0.95, AUC of T2 stage was 0.99, AUC of T3 stage was 0.96, and AUC of T4 stage was 1.00.Conclusion:Faster R-CNN AI might be an effective and objective method to build the platform for predicting rectal cancer T-staging.Trial registration:chictr.org.cn: ChiCTR1900023575; http://www.chictr.org.cn/showproj.aspx?proj=39665.

简介：Objective:Weretrospectivelyanalyzedtheclinicalprognosticvalueofthe8theditionoftheAmericanJointCommitteeonCancer(AJCC)stagingsystemforluminalAbreastcancer.Methods:Usingboththeanatomicandprognosticstaginginthe8theditionofAJCCcancerstagingsystem,werestagedpatientswithluminalAbreastcancertreatedattheBreastDiseaseCenter,PekingUniversityFirstHospitalfrom2008to2014.Follow-updataincluding5-yeardiseasefreesurvival(DFS),overallsurvival(OS)andotherclinic-pathologicaldatawerecollectedtoanalyzethedifferencesbetweenthetwostagingsubgroups.Results:Thisstudyincluded421patientswithluminalAbreastcancer(medianfollow-up,61months).The5-yearDFSandOSrateswere98.3%and99.3%,respectively.Significantdifferencesin5-yearDFSbutnotOSwereobservedbetweendifferentanatomicdiseasestages.Significantdifferenceswereobservedinboth5-yearDFSandOSbetweendifferentprognosticstages.Applicationoftheprognosticstagingsystemresultedinassignmentof175of421patients(41.6%)toadifferentgroupcomparedtotheiroriginalanatomicstages.Intotal,102of103patientswithanatomicstageIIAchangedtoprognosticstageIB,and24of52patientswithanatomicstageIIBchangedtoprognosticstageIB,while1changedtoprognosticstageIIIB.Twenty-twoof33patientswithanatomicstageIIIAweredown-stagedtoIIAwhenstagedbyprognosticstagingsystem,andtheother11patientsweredown-stagedtoIIB.TwopatientswithanatomicstageIIIBweredown-stagedtoIIIA.AmongsevenpatientswithanatomicstageIIICcancer,twoweredown-stagedtoIIIAandfourweredown-stagedtostageIIIB.Conclusions:The8theditionofAJCCprognosticstagingsystemisanimportantsupplementtothebreastcancerstagingsystem.Moreclinicaltrialsareneededtoproveitsabilitytoguideselectionofpropersystemictherapyandpredictprognosisofbreastcancer.

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