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癌症（英文版）

癌症（英文版）

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Chinese Journal of Cancer
《癌症》从1992年起，首批进入中国科技核心期刊，是中国科学引文数据库来源期刊，中国学术期刊综合评价数据库来源期刊和中国学术期刊（光盘版）全文收录期刊。被收录入MEDLINE期刊。
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  • 被引量：1434
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  • 国内刊号/CN：44-1195/R
    国际刊号/ISSN：1000-467X
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  • 主管单位：中华人民共和国教育部
    主办单位：中山大学肿瘤防治中心
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  • 广东省优秀期刊鼓励奖，1991年
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癌症（英文版） >2009年第2期

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  • 摘要：Background: Hypoalbuminemia adversely affects the clinical outcomes of various cancers. The purpose of this study was to estimate the prognostic value of hypoalbuminemia 3–5 weeks after treatment in patients with metastatic renal cell carcinoma (mRCC) who received sorafenib or sunitinib as first-line treatment. Methods: In this single-center, retrospective study, we assessed the progression-free survival (PFS) and overall sur-vival (OS) of 184 mRCC patients who received first-line sorafenib or sunitinib treatment. PFS and OS were compared between patients with post-treatment hypoalbuminemia (post-treatment albumin level <36.4 g/L) and those with normal post-treatment albumin level (albumin level ≥36.4 g/L). The Memorial Sloan Kettering Cancer Center (MSKCC)risk model stratified mRCC patients into three risk categories. Prognostic values of all patient characteristics including MSKCC risk category were determined by using univariate and multivariate Cox regression models. Prognostic value was further determined using the Harrell concordance index and receiver operating characteristic curve analysis. Results: The median PFS and OS of the 184 patients were 11 months (95% confidence interval [CI] 9–12 months) and 23 months (95% CI 19–33 months), respectively. Patients with post-treatment hypoalbuminemia had significantly shorter median PFS (6 months [95% CI 5–7 months]) and OS (11 months [95% CI 9–15 months]) than patients who had normal post-treatment albumin levels (PFS: 12 months [95% CI 11–16 months], P < 0.001; OS: 31 months [95% CI 24–42 months], P < 0.001), respectively. Multivariate analysis showed that post-treatment hypoalbuminemia was an independent predictor of PFS (hazard ratio [HR], 2.113; 95% CI 1.390–3.212; P < 0.001) and OS (HR, 2.388; 95% CI 1.591–3.585; P < 0.001). Post-treatment hypoalbuminemia could also be combined with the MSKCC risk category for better prediction about OS. The model that included post-treatment hypoalbuminemia and MSKCC risk category improved the predictive accuracy for PFS and OS (c-index: 0.68 and 0.73, respectively) compared with the basic MSKCC risk model (c-index: 0.67 and 0.70, respectively). The prognostic values for PFS and OS of the integrated MSKCC risk model involving post-treatment hypoalbuminemia were significantly more accurate than the basic MSKCC risk model using likelihood ratio analysis (both P < 0.001). Conclusions: Post-treatment hypoalbuminemia can be considered an independent prognostic factor for patients with mRCC who undergo first-line treatment with tyrosine kinase inhibitors. Additionally, integrating post-treatment serum albumin level into the basic MSKCC risk model can improve the accuracy of this model in predicting patient overall survival and progression-free survival.
  • 摘要：Metformin, an inexpensive and well-tolerated oral agent commonly used in the first-line treatment of type 2 dia-betes, has become the focus of intense research as a candidate anticancer agent. Here, we discuss the potential of metformin in cancer therapeutics, particularly its functions in multiple signaling pathways, including AMP-activated protein kinase, mammalian target of rapamycin, insulin-like growth factor, c-Jun N-terminal kinase/mitogen-activated protein kinase (p38 MAPK), human epidermal growth factor receptor-2, and nuclear factor kappaB pathways. In addi-tion, cutting-edge targeting of cancer stem cells by metformin is summarized.
  • 摘要：Background: Nasopharyngeal carcinoma (NPC) shows a high proportion of lymph node metastasis, and treatment guidelines have been developed for positive nodes. However, no irradiation guidelines have been proposed for patients with enlarged neck lymph nodes (ENLNs) that do not meet the radiological criteria of 10 mm in diameter for positive lymph nodes. This study aimed to determine the prognostic value and radiation dose for ENLNs in N0-cate-gory NPC patients treated with intensity-modulated radiotherapy (IMRT). Methods: We reviewed the medical data of 251 patients with non-metastatic, N0-category NPC treated with IMRT. Receiver operating characteristic curves were used to calculate the cut-off value of the ENLN diameter for the prediction of disease failure.The biological equivalent dose (BED) for ENLNs was calculated. Patient survival was compared between the smal and large ENLN groups. Independent prognostic factors were identified using the Cox proportional hazards model. Results: The estimated 4-year regional relapse-free survival rate was higher in patients with ENLNs ≥5.5 mm thanin those with ENLNs <5.5 mm (100% vs. 98.8%, P= 0.049), whereas disease-free, overall, and distant metastasis-free survival rates were similar between the two groups. After adjusting for various factors, ENLN diameter was not identi-fied as an independent prognostic factor (P > 0.05 for all survival rates). In the subgroup analysis, patients receiving BED ≥72 Gy had a similar prognosis as patients receiving BED <72 Gy in both the small and large ENLN groups. Themultivariate analysis also confirmed that BED≥72 Gy was not associated with significantly improved prognosis in patients with N0-category NPC. Conclusions: A BED of 72 Gy to ENLNs is considerably sufficient to provide a clinical benefit to patients with N0-cate-gory NPC. Prospective studies are warranted to validate the findings in the present study.
  • 摘要：Since the beginning of 2017, Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology, which sparkle diverse thoughts, interesting communications, and potential collabora-tions among researchers all over the world. In this article, 10 more questions are presented as followed. Question 40. Why do mice being used as tumorigenesis models raised in different places or different conditions possess differ-ent tumor formation rate? Question 41. How could we generate more effective anti-metastasis drugs? Question 42. What is the molecular mechanism underlying heterogeneity of cancer cachexia in patients with the same pathologic type? Question 43. Will patients with oligo-metastatic disease be curable by immunotherapy plus stereotactic body radiotherapy? Question 44. Can the Warburg effect regulation be targeted for cancer treatment? Question 45. Why do adenocarcinomas seldom occur in the small intestine? Question 46. Is Epstein–Barr virus infection a causal factor for nasal natural killer/T cell lymphoma formation? Question 47. Why will not all but very few human papillomavirus-infected patients eventually develop cervical cancer? Question 48. Why do cervical carcinomas induced by human papilloma virus have a low mutation rate in tumor suppressor genes? Question 49. Can viral infection trigger lung cancer relapse?
  • 摘要：Since the beginning of 2017,Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology,which sparkle diverse thoughts,interesting communications,and potential collaborations among researchers all over the world.In this article,seven more questions are presented as followed.Question 50.When tumor cells spread from primary site to distant sites,are they required to be "trained" or "armed" in the bone marrow niche prior to colonizing soft tissues? Question 51.Are there tipping points during cancer progression which can be identified for manipulation? Question 52.Can we replace molecular biomarkers by network biomarkers? Question 53.Are conventional inhibitors of key cellular processes such as cell proliferation and differentiation more effective than targeted chemotherapeutics that antagonize the downstream cell signaling network via cell-surface receptors such as epidermal growth factor receptor (EGFR),vascular endothelial growth factor receptor (VEGFR) and c-Met,or intraceilular receptors such as androgen receptor (AR) and estrogen receptor (ER),by drugs like erlotinib,sunitinib and cabozantinib,or enzalutamide and tomoxifen? Question 54.How can we robustly identify the candidate causal event of somatic genome alteration (SGA) by using computational approach? Question 55.How can we systematically reveal the immune evasion mechanism exploited by each tumor and utilize such information to guide targeted therapy to restore immune sensitivity? Question 56.Can the nasopharyngeal carcinoma (NPC) patients with sarcomatoid carcinoma (SC) subtype benefit from more specific targeted therapy?
  • 摘要：Multidrug resistance (MDR) occurs frequently after long-term chemotherapy,resulting in refractory cancer and tumor recurrence.Therefore,combatting MDR is an important issue.Autophagy,a self-degradative system,universally arises during the treatment of sensitive and MDR cancer.Autophagy can be a double-edged sword for MDR tumors:it participates in the development of MDR and protects cancer cells from chemotherapeutics but can also kill MDR cancer cells in which apoptosis pathways are inactive.Autophagy induced by anticancer drugs could also activate apoptosis signaling pathways in MDR cells,facilitating MDR reversal.Therefore,research on the regulation of autophagy to combat MDR is expanding and is becoming increasingly important.We summarize advanced studies of autophagy in MDR tumors,including the variable role of autophagy in MDR cancer cells.
  • 摘要：Background:Mortality outcomes in trials of low-dose computed tomography (CT) screening for lung cancer are inconsistent.This study aimed to evaluate whether CT screening in urban areas of China could reduce lung cancer mortality and to investigate the factors that associate with the screening effect.Methods:A decision tree model with three scenarios (low-dose CT screening,chest X-ray screening,and no screening) was developed to compare screening results in a simulated Chinese urban cohort (100,000 smokers aged 45-80 years).Data of participant characteristics were obtained from national registries and epidemiological surveys for estimating lung cancer prevalence.The selection of other tree variables such as sensitivities and specificities of low-dose CT and chest X-ray screening were based on literature research.Differences in lung cancer mortality (primary outcome),false diagnoses,and deaths due to false diagnosis were calculated.Sensitivity analyses were performed to identify the factors that associate with the screening results and to ascertain worst and optimal screening effects considering possible ranges of the variables.Results:Among the 100,000 subjects,there were 448,541,and 591 lung cancer deaths in the low-dose CT,chest X-ray,and no screening scenarios,respectively (17.2％ reduction in low-dose CT screening over chest X-ray screening and 24.2％ over no screening).The costs of the two screening scenarios were 9387 and 2497 false diagnoses and 7 and 2 deaths due to false diagnosis among the 100,000 persons,respectively.The factors that most influenced death reduction with low-dose CT screening over no screening were lung cancer prevalence in the screened cohort,low dose CT sensitivity,and proportion of early-stage cancers among low-dose CT detected lung cancers.Considering all possibilities,reduction in deaths (relative numbers) with low-dose CT screening in the worst and optimal cases were 16 (5.4％) and 288 (40.2％) over no screening,respectively.Conclusions:In terms of mortality outcomes,our findings favor conducting low-dose CT screening in urban China.However,approaches to reducing false diagnoses and optimizing important screening conditions such as enrollment criteria for screening are highly needed.
  • 摘要：Background:Laparoscopic hepatectomy for hepatocellular carcinoma (HCC) located in segment Ⅵ,Ⅶ,or Ⅷ of the liver is usually difficult because of poor operative exposure,due to the unique anatomical structure.In this study,we evaluated the practice of laparoscopic hepatectomy with the left jackknife position for patients with HCC located in segment Ⅵ,Ⅶ,or Ⅷ.Methods:A total of 10 patients were enrolled to undergo laparoscopic hepatectomy with the left jackknife position.Tumors located in segment Ⅵ,Ⅶ,or Ⅷ were assessed by preoperative dynamic computed tomography or magnetic resonance imaging.Operation time,intraoperative blood loss,postoperative fasting time,postoperative drainage time,major postoperative complications,and duration of postoperative hospital stay were recorded.Results:All surgeries were successfully completed.None of the patients required conversion to open surgery during the procedure,and no serious postoperative complications were observed.The median tumor size was 31 mm (range 23-41 mm) in diameter,the mean operation time was 166 ± 38 min,the mean intraoperative blood loss was 220 ± 135 mL,and the median postoperative hospital stay was 4 days (range 2-7 days).Conclusions:For HCC located in segment Ⅵ,Ⅶ,or Ⅷ,laparoscopic hepatectomy with this novel position—the left jackknife position—is safe and effective during tumor resection by exposing a sufficient operating field.
  • 摘要：Introduction:Population-based cancer registration data are collected by the National Central Cancer Registry in China every year.Cancer incident cases and cancer deaths in 2013 were analyzed.Methods:Through the procedure of quality control,reported data from 255 registries were accepted to establish the national database for cancer estimates.Incidences and mortalities were calculated with stratification by area (urban/ rural),sex (male/female),age group (0,1-4,5-9,10-14...80-84,and 85-year-old and above),and cancer site.The structure of Segi's population was used for the calculation of age-standardized rates (ASR).Top 10 most common cancers and leading causes of cancer deaths were listed.Results:In 2013,3,682,200 new cancer cases and 2,229,300 cancer deaths were estimated in China based on the pooled data from 255 cancer registries,covering 16.6S％ of the national population.The incidence was 270.59/100,000,with an ASR of 186.15/100,000;the mortality was 166.83/100,000,with an ASR of 108.94/100,000.The top 10 most common cancer sites were the lung,stomach,liver,colorectum,female breast,esophagus,thyroid,cervix,brain,and pancreas.The ten leading causes of cancer deaths were lung cancer,liver cancer,gastric cancer,esophageal cancer,colorectal cancer,pancreatic cancer,female breast cancer,brain tumor,leukemia,and lymphoma.Conclusions:Cancer leaves serious disease burden in China with high incidence and mortality.Lung cancer was the most common cancer and the leading cause of cancer death in China.Efficient control strategy is needed,especially for major cancers.
  • 摘要：Five-year survival rate for patients with all cancers combined,in China,is only 30.9％,which is much lower than those in developed countries.The three main reasons for the low cancer curative rates in China include differences in the spectrum of cancer types,in early detection rates,and in the percentage of cancer patients receiving standardized treatment between China and developed countries.The most important mechanism for improving the curative rate is to improve early detection rates of major cancers in China using novel and affordable technologies that can be operated at home by the patients themselves.This attempt could be helpful in setting up a practical example for other developing countries with limited medical resources and a limited number of healthcare practitioners.
  • 摘要：Background:The increasing prevalence of colorectal cancer (CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment.We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.Methods:We conducted a multicenter,cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014.Each enrolled patient was interviewed using a structured questionnaire.All expenditure data were inflated to the 2014 Chinese Yuan (CNY;1 CNY =0.163 USD).We quantified the overall expenditure and financial burden and by subgroup (hospital type,age at diagnosis,sex,education,occupation,insurance type,household income,clinical stage,pathologic type,and therapeutic regimen).We then performed generalized linear modeling to determine the factors associated with overall expenditure.Results:A total of 2356 patients with a mean age of 57.4 years were included,57.1％ of whom were men;13.9％ of patients had stage Ⅰ cancer;and the average previous-year household income was 54,525 CNY.The overall average direct expenditure per patient was estimated to be 67,408 CNY,and the expenditures for stage Ⅰ,Ⅱ,Ⅲll,and Ⅳ disease were 56,099 CNY,59,952 CNY,67,292 CNY,and 82,729 CNY,respectively.Non-medical expenditure accounted for 8.3％ of the overall expenditure.The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY,which accounted for 59.9％ of their previous-year household income and caused 75.0％ of families to suffer an unmanageable financial burden.Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups (P ＜ 0.05),except for sex.Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more,whereas those with a lower household income and those who underwent surgery spent less (all P ＜ 0.05).Conclusions:For patients in China,direct expenditure for the diagnosis and treatment of CRC seemed catastrophic,and non-medical expenditure was non-ignorable.The financial burden varied among subgroups,especially among patients with different clinical stages of disease,which suggests that,in China,CRC screening might be cost-effective.
  • 摘要：Background:To protect neurological tissues,underdosing occurs in most cases ofT4 nasopharyngeal carcinoma (NPC) with intracranial extension.In this study,we aimed to evaluate the effect of dosimetric inadequacy on local control and late neurological toxicities for patients treated with intensity-modulated radiotherapy (IMRT) plus chemotherapy.Methods:We prospectively enrolled patients who had non-metastatic T4 NPC with intracranial extension treated between January 2009 and November 2013.The prescribed dose was 66.0-70.4 Gy to the primary planning target volume (primary gross tumor volume [GTVp;i.e.,the nasopharyngeal tumor] + 5.0 mm).Dose-volume histogram parameters were calculated,including minimum point dose (Dmin) and dose to 95％ of the target volume (D9s).All patients received chemotherapy with the cisplatin,5-fluorouracil,and docetaxel regimen.Survivals were estimated using the Kaplan-Meier method and compared using the log-rank test.Results:In total,41 patients were enrolled.The local partial response rate was 87.8％ after induction chemotherapy.With a median follow-up of 51 months,7 patients experienced failure in the nasopharynx;the 3-year local failure-free survival and overall survival rates of the 41 patients were 87.4％ and 90.2％,respectively.The actual mean Dmin to the GTVp was 55.2 Gy (range 48.3-67.3 Gy),and D9s was 61.6 Gy (range 52.6-69.0 Gy).All doses received by neurological organs remained well within their dose constraints.No patients developed temporal lobe necrosis or other neurological dysfunctions.Conclusions:With relative underdosed IMRT plus effective chemotherapy,the patients achieved satisfactory local control with few late toxicities of the central nervous system.Determining the acceptable extent of dosimetric inadequacy requires further exploration.
  • 摘要：Background:Reduced expression of tripartite motif-containing 3 (TRIM3) has been reported to be involved in the pathogenesis of human glioblastoma.In our previous research,we found that TRIM3 expression was markedly reduced in human primary hepatocellular carcinoma (HCC) tissues and that low TRIM3 expression was associated with short survival of HCC patients.However,the role of TRIM3 in liver cancer remains unknown.This study aimed to investigate the function of TRIM3 in liver cancer cells.Methods:The protein levels of TRIM3 in five liver cancer cell lines (SK-Hep1,Hep3B,Huh7,HepG2,Bel-7402) and one normal liver cell line (L02) were detected with Western blotting.HepG2 and Bel-7402 cells with IowTRIM3 expression were infected with recombinant lentiviruses overexpressing TRIM3 (LV-TRIM3),whereas Huh7 and Hep3B cells with high TRIM3 expression were transfected with TRIM3-targeted small interfering RNA (siTRIM3).The functions of TRIM3 in the proliferation,colony formation,cell cycle,migration,invasion,and apoptosis of the above cell lines were examined.The effect of TRIM3 on tumor growth and metastases in nude mice was also investigated.Results:TRIM3 was overexpressed in HepG2 and Bel-7402 cells with LV-TRIM3 infection,which further reduced proliferation,colony formation,migration,and invasion of both cell lines.Cell cycle analysis showed thatTRIM3 overexpression induced G0/G1 phase arrest in HepG2 and Bel-7402 cells.Moreover,apoptosis was not increased in HepG2 or Bel-7402 cells overexpressing TRIM3.Contrarily,silencing TRIM3 expression in Huh7 and Hep3B cells by siTRIM3 led to significantly decreased percentages of both cells in the G0/G1 phase and promoted cell proliferation,colony formation,migration,and invasion.In vivo experiment results confirmed thatTRIM3 overexpression suppressed tumor growth and metastasis.Conclusions:TRIM3 plays a tumor-suppressing role in the regulation of liver cancer development by reducing cell proliferation through cell cycle arrest at the G0/G1 phase.
  • 摘要：Since the beginning of 2017,Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology,which sparkle diverse thoughts,interesting communications,and potential collaborations among researchers all over the world.In this article,10 more questions are presented as followed.Question 57.What are the major stresses that drive the formation,progression,and metastasis of a cancer? Question 58.What is the mechanism responsible for altering an acidic intracellular pH and a basic extracellular pH in normal tissue cells to a basic intracellular pH and an acidic extracellular pH in cancer cells,a fundamental and yet largely ignored phenomenon? Question 59.Where are the tumor-associated plasma microRNAs from in cancer patients? Question 60.Can we identify mechanisms employed by tumor subpopulations to evade standard therapies and seed relapse/metastatic tumors before treatment? Question 61.Why are mutation rates in epidermal growth factor receptor (EGFR) and erb-b2 receptor tyrosine kinase 2 (ERBB2) higher in lung cancer from never smokers than that from smokers? Question 62.Does tumor vasculogenic mimicry contribute to the resistance against antiangiogenic therapy in renal cancer? Question 63.What molecular targeted drugs would be effective for non-clear cell renal cell carcinoma (RCC),especially metastatic papillary RCC and chromophobe RCC? Question 64.Can it be more effective by targeting both the vascular endothelial growth factor receptor (VEGFR) and MET signaling pathways in sporadic metastatic papillary renal cell carcinoma (RCC)? Question 65.What are the predictive biomarkers that may be used to identify the renal cell carcinoma (RCC) patients who can benefit from immune checkpoint inhibitor treatment? Question 66.How do we identify predictive molecular biomarkers to stratify clear cell renal cell carcinoma patients for tarqeted therapies?
  • 摘要：Background:Inflammation-based indexes have been used to predict survival and recurrence in cancer patients.Systemic immune-inflammation index (SII) was reported to be associated with prognosis in some malignant tumors.In the present study,we aimed to explore the association between SII and the prognosis of patients with gastric cancer.Methods:We retrospectively analyzed data from 444 gastric cancer patients who underwent gastrectomy at the First Affiliated Hospital of Sun Yat-sen University between January 1994 and December 2005.Preoperative SII was calculated.The Chi square test or Fisher's exact test was used to determine the relationship between preoperative SII and clinicopathologic characteristics.Overall survival (OS) rates were estimated using the Kaplan-Meier method,and the effect of SII on OS was analyzed using the Cox proportional hazards model.Receiver operating characteristic (ROC) curves were used to compare the predictive ability of SII,NLR,and PLR.Results:SII equal to or higher than 660 was significantly associated with old age,large tumor size,unfavorable Borrmann classification,advanced tumor invasion,lymph node metastasis,distant metastasis,advanced TNM stage,and high carcino-embryonic antigen level,high neutrophil-lymphocyte ratio,and high platelet-lymphocyte ratio (all P ＜ 0.05).High SII was significantly associated with unfavorable prognosis (P ＜ 0.001) and SII was an independent predictor for OS (P =0.015).Subgroups analysis further showed significant associations between high SII and short OS in stage Ⅰ,Ⅱ,Ⅲ subgroups (all P ＜ 0.05).SII was superior to NLR and PLR for predicting OS in patients with gastric cancer.Conclusion:Preoperative SII level is an independent prognostic factor for OS in patients with gastric cancer.
  • 摘要：Background:Erythrocytosis,a rare paraneoplastic syndrome,generally occurs in patients with clear cell renal cell carcinoma and has never been reported in patients with chromophobe renal cell carcinoma.Case presentation:We report a case of a young man suffering from a giant (22-cm) mass on his left kidney.Because of a history of polycythemia vera,the patient had been treated for the condition for 9 years.Radical nephrectomy was successfully performed,and the postoperative pathologic examination confirmed a diagnosis ofchromophobe renal cell carcinoma.Unexpectedly,the symptom of erythrocytosis disappeared after the surgery.Further examination and analysis were performed,and we finally attributed his erythrocytosis to chromophobe renal cell carcinoma.Conclusions:Chromophobe renal cell carcinoma could cause erythrocytosis,but the clear-cut mechanism needs further research.Secondary erythrocytosis such as those related with renal tumors should be taken into consideration during the diagnosis of polycythemia vera.
  • 摘要：Background:The prognostic significance of ABO blood type for lymphoma is largely unknown.We evaluated the prognostic role of ABO blood type in patients with extranodal natural killer (NK)/T-cell lymphoma (ENKTL).Methods:We retrospectively analyzed clinical data of 697 patients with newly diagnosed ENKTL from three cancer centers.The prognostic value of ABO blood type was evaluated using Kaplan-Meier curves and Cox proportional hazard models.The prognostic values of the International Prognostic Index (IPI) and the Korean Prognostic Index (KPI) were also evaluated.Results:Compared with patients with blood type O,those with blood type non-O tended to display elevated baseline serum C-reactive protein levels (P =0.038),lower rate of complete remission (P =0.005),shorter progression-free survival (PFS,P ＜ 0.001),and shorter overall survival (OS,P =0.001).Patients with blood type O/AB had longer PFS (P ＜ 0.001) and OS (P =0.001) compared with those with blood type A/B.Multivariate analysis demonstrated that age ＞60 years (P ＜ 0.001),mass ＞5 cm (P =0.001),stage Ⅲ/Ⅳ (P ＜ 0.001),elevated serum lactate dehydrogenase (LDH) levels (P =0.001),and blood type non-O were independent adverse predictors of OS (P =0.001).ABO blood type was found to be superior to both the IPI in discriminating patients with different outcomes in the IPI low-risk group and the KPI in distinguishing between the intermediate-to-low-and high-to-intermediate-risk groups.Conclusions:ABO blood type was an independent predictor of clinical outcome for patients with ENKTL.
  • 摘要：Neuroendocrine carcinoma of the breast (NECB) accounts for approximately 0.3%-0.5% of all breast cancers [1, 2]. Due to the rarity of NECB, current understanding of this disease in China is limited to case reports and small case series, and large data analysis is still lacking. Therefore, we conducted the most comprehensive literature search to date, aiming to analyze the clinicopathologic characteristics as well as treatment and outcome of NECB in the Chinese population.
  • 摘要：Background: Right upper lobectomy (RUL) for lung cancer with different dissecting orders involves the most vari-able anatomical structures, but no studies have analyzed its effects on postoperative recovery. This study compared the conventional surgical approach, VAB (dissecting pulmonary vessels first, followed by the bronchus), and the alter-native surgical approach, aBVA (dissecting the posterior ascending arterial branch first, followed by the bronchus and vessels) on improving surgical feasibility and postoperative recovery for lung cancer patients. Methods: According to the surgical approach, consecutive lung cancer patients undergoing RUL were grouped into aBVA and VAB cohorts. Their clinical, pathologic, and perioperative characteristics were collected to compare periop-erative outcomes. Results: Three hundred one patients were selected (109 in the aBVA cohort and 192 in the VAB cohort). The mean operation time was shorter in the aBVA cohort than in the VAB cohort (164 vs. 221 min, P < 0.001), and less blood loss occurred in the aBVA cohort (92 vs. 141 mL, P < 0.001). The rate of conversion to thoracotomy was lower in the aBVA cohort than in the VAB cohort (0% vs. 11.5%, P < 0.001). The mean duration of postoperative chest drainage was shorter in the aBVA cohort than in the VAB cohort (3.6 vs. 4.5 days, P = 0.001). The rates of postoperative complica-tions were comparable (P = 0.629). The median overall survival was not arrived in both cohorts (P > 0.05). The median disease-free survival was comparable for all patients in the two cohorts (not arrived vs. 41.97 months) and for patients with disease recurrences (13.25 vs. 9.44 months) (both P > 0.05). The recurrence models in two cohorts were also comparable for patients with local recurrences (6.4% vs. 7.8%), distant metastases (10.1% vs. 8.3%), and both (1.8% vs. 1.6%) (all P > 0.05). Conclusions: Dissecting the right upper bronchus before turning over the lobe repeatedly and dissecting veins via the aBVA approach during RUL would promote surgical feasibility and achieve comparable postoperative recovery for lung cancer patients.
  • 摘要：Background: Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are a heterogeneous group of rare tumors. Many issues in terms of epidemiologic features, pathogenesis, and treatment of GEP-NENs are still under discussion. Our study aimed to analyze the clinicopathologic characteristics and prognosis of Chinese patients with GEP-NENs. Methods: Complete clinicopathologic data and survival information of 1183 patients with GEP-NENs treated between 2005 and 2015 were collected from five medical centers in Guangdong Province, China. Patient survival was estimated using the Kaplan–Meier method and analyzed using the log-rank test; prognostic factors were analyzed using the Cox proportional hazards model. Results: The most common tumor location was the rectum (37.4%), followed by the pancreas (28.1%), stomach (20.7%), small intestine (7.2%), appendix (3.4%), and colon (3.3%). After initial definitive diagnosis, 1016 (85.9%) patients underwent surgery. The 1-, 3-, and 5-year overall survival (OS) rates for the entire cohort were 87.9%, 78.5%, and 72.8%, respectively. The 3-year OS rates of patients with G1, G2, and G3 tumors were 93.1%, 82.7%, and 43.1%, respectively (P < 0.001). The 3-year OS rates of patients with stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ tumors were 96.0%, 87.3%, 64.0%, and 46.8%, respectively (P < 0.001). Patients with distant metastasis who underwent palliative surgery had a longer survival than those who did not (P = 0.003). Similar survival benefits of palliative surgery were observed in patients with neuroendocrine tumor (P = 0.031) or neuroendocrine carcinoma (P = 0.046). In multivariate analysis, age, grade, N category, M category, and surgery were found to be independent prognostic factors. Conclusions: Patients with GEP-NENs who are women, younger than 50 years old, have smaller tumor size, have lower tumor grade, have lower T/N/M category, and who undergo surgery can have potentially longer survival time. Our data showed that surgery can improve the prognosis of GEP-NEN patients with distant metastasis. However, randomized controlled trials need to be conducted to establish the optimal criteria for selecting patients to undergo surgery.
  • 摘要：Background: Patients with intermediate to advanced hepatocellular carcinoma (HCC) are most commonly treated with transarterial chemoembolization (TACE). Previous studies showed that TACE combined with recombinant human adenovirus type 5 (H101) may provide a clinical survival benefit. In the present study, we aimed to determine the survival benefit of TACE with or without H101 for patients with intermediate to advanced HCC and to develop an effective nomogram for predicting individual survival outcomes of these patients. Methods: We retrospectively collected data from 590 patients with intermediate to advanced HCC who were treated at Sun Yat-sen University Cancer Center between January 2007 and July 2015. After propensity score matching, 238 patients who received TACE with H101 (TACE with H101 group) and 238 patients who received TACE without H101 (TACE group) were analyzed. Overall survival (OS) was evaluated using the Kaplan–Meier method; the nomogram was developed based on Cox regression analysis. Discrimination and calibration were measured using the concordance index (c-index) and calibration plots. Results: Clinical and radiologic features were similar between the two groups. OS rates were significantly lower in the TACE group than in the TACE with H101 group (1-year OS rate, 53.8% vs. 61.3%; 2-year OS rate, 33.4% vs. 44.2%;3-year OS rate, 22.4% vs. 40.5%; all P < 0.05). Multivariate Cox regression analysis for the entire cohort showed that alpha-fetoprotein level, alkaline phosphatase level, tumor size, metastasis, vascular invasion, and TACE with or without H101 were independent factors for OS, all of which were included in the nomogram. Calibration curves showed good agreement between nomogram-predicted survival and observed survival. The c-index of the nomogram for predict-ing OS was 0.716 (95% confidence interval 0.686–0.746). Conclusions: TACE plus H101 extends the survival of patients with intermediate to advanced HCC. Our proposed nomogram provides individual survival prediction and stratification for patients with intermediate to advanced HCC who receive TACE with or without H101.
  • 摘要：Introduction: Colorectal cancer (CRC) is a common type of neoplasm. This study examined the spatio-temporal distribution of the CRC incidence in Guangzhou during 2010–2014. Methods: Colorectal cancer incidence data were obtained from the Guangzhou Cancer Registry System. Spatial autocorrelation analysis and a retrospective spatio-temporal scan were used to assess the spatio-temporal cluster distribution of CRC cases. Results: A total of 14,618 CRC cases were registered in Guangzhou during 2010–2014, with a crude incidence of 35.56/100,000 and an age-standardized rate of incidence by the world standard population (ASRIW) of 23.58/100,000. The crude incidence increased by 19.70% from 2010 (32.88/100,000) to 2014 (39.36/100,000) with an average annual percentage change (AAPC) of 4.33%. The AAPC of ASRIW was not statistically significant. The spatial autocorrelation analysis revealed a CRC incidence hot spot in central urban areas in Guangzhou City, which included 25 streets in southwestern Baiyun District, northwestern Haizhu District, and the border region between Liwan and Yuexiu Dis-tricts. Three high- and five low-incidence clusters were identified according to spatio-temporal scan of CRC incidence clusters. The high-incidence clusters were located in central urban areas including the border regions between Bai-yun, Haizhu, Liwan, and Yuexiu Districts. Conclusions: This study revealed the spatio-temporal cluster pattern of the incidence of CRC in Guangzhou. This information can inform allocation of health resources for CRC screening.
  • 摘要：Dear editor,Radiotherapy is a cornerstone in the management of anal or rectal cancer. Because elderly patients are often excluded from clinical trials, little is known about radiotherapy’s therapeutic index (efficacy/toxicity ratio) in the geriatric population [1]. Still, the ageing of population imposes the challenge to treat older cancer patients and probably to adjust their treatment [2]. A few studies reported data on radiation-induced toxicities in nonagenarian patients, but data on efficacy are still scarce. For rectal cancer, preoperative radiotherapy programs were suggested to be feasible in elderly patients [3–5], with a preference for short protocols without chemotherapy [4]. For anal cancer, the safety of radiochemotherapy was only reported in limited sets of elderly patients [6]. The objective of the present study was to report efficacy and toxicity data on the radiotherapy treatment of nonagenarian patients with anal or rectal cancer.We analyzed the data of 34 nonagenarian patients with anal or rectal cancers: 27 (79.4%) with a rectal adenocarcinoma and 7 (20.6%) with an anal canal squamous cell carcinoma.
  • 摘要：Since the beginning of 2017, Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology, which sparkle diverse thoughts, interesting communications, and potential collabora-tions among researchers all over the world. In this article, 9 more questions are presented as followed. Question 67. How could we overcome the resistance of hepatocellular carcinoma against chemotherapeutics? Question 68. Is pursuit of non-covalent small-molecule binders of RAS proteins viable as a strategy of cancer drug discovery? Ques-tion 69. In what oligomeric structures do RAS proteins signal? Question 70. How can we achieve non-invasive early detection and diagnosis of lung cancer? Question 71. Does genetic information influence the volatolome enabling diagnosis of lung cancer with genetic mutations via cell headspace or breath analysis? Question 72. Is heavy ion beam radiotherapy effective to kill cancer stem cells? Question 73. Is there any diversity among different types of cancer in terms of sensitivity to heavy ion beam radiotherapy? Question 74. Can targeted alpha-particle therapy augment the effect of carbon ion radiotherapy on malignancies? Question 75. How does chromosomal instability drive tumor progression?
  • 摘要：Background: In China, most patients with nasopharyngeal carcinoma (NPC) are diagnosed at a late stage and con-sequently have a poor prognosis. This study aimed to investigate potential factors associated with the clinical stage of NPC at diagnosis. Methods: Data were obtained from 118 patients with early-stage NPC and 274 with late-stage NPC who were treated at Sun Yat-sen University Cancer Center between August 2014 and July 2015. Patients were individually matched by age, sex, and residence, and a conditional logistic regression model was applied to assess the associa-tions of clinical stage at diagnosis with socioeconomic status indicators, knowledge of NPC, physical examinations, patient interval, and risk factors for NPC. Results: Although knowledge of early NPC symptoms, smoking cessation, and patient interval were important fac-tors, the number of cigarettes smoked per day, motorbike ownership, and physical examination exhibited the strong-est associations with the clinical stage of NPC at diagnosis. Compared with smoking fewer than ten cigarettes a day, smoking 10–30 cigarettes [odds ratio (OR) 4.03; 95% confidence interval (CI) 1.11–14.68] or more than 30 cigarettes (OR 11.46; 95% CI 1.26–103.91) was associated with an increased risk of late diagnosis. Compared with not owning a motorbike, owning a motorbike (OR 0.38; 95% CI 0.23–0.64) was associated with early diagnosis. Subjects who under-went physical examinations were less likely to receive a late diagnosis than those who did not undergo examinations (OR 0.50; 95% CI 0.28–0.89). However, indicators of wealth were not significant factors. Conclusions: Initiatives to improve NPC patient prognosis should aim to promote knowledge about early symptoms and detection, health awareness, and accessibility to health facilities among all patients, regardless of socioeconomic status.
  • 摘要：Flavonoids are polyphenols that are found in numerous edible plant species. Data obtained from preclinical and clini-cal studies suggest that specific flavonoids are chemo-preventive and cytotoxic against various cancers via a multi-tude of mechanisms. However, the clinical use of flavonoids is limited due to challenges associated with their effective use, including (1) the isolation and purification of flavonoids from their natural resources; (2) demonstration of the effects of flavonoids in reducing the risk of certain cancer, in tandem with the cost and time needed for epidemiologi-cal studies, and (3) numerous pharmacokinetic challenges (e.g., bioavailability, drug–drug interactions, and metabolic instability). Currently, numerous approaches are being used to surmount some of these challenges, thereby increas-ing the likelihood of flavonoids being used as chemo-preventive drugs in the clinic. In this review, we summarize the most important challenges and efforts that are being made to surmount these challenges.
  • 摘要：Background: Thymoma is an uncommon tumor without a widely accepted standard care to date. We aimed to investigate the clinicopathologic variables of patients with thymoma and identify possible predictors of survival and recurrence after initial resection. Methods: We retrospectively selected 307 patients with thymoma who underwent complete resection at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (Beijing, China) between January 2003 and December 2014. The associations of patients' clinical characteristics with prognosis were estimated using Cox regression and Kaplan–Meier survival analyses. Results: During follow-up (median, 86 months; range, 24–160 months), the 5- and 10-year disease-free survival (DFS) rates were 84.0% and 73.0%, respectively, and the 5- and 10-year overall survival (OS) rates were 91.0% and 74.0%, respectively. Masaoka stage (P < 0.001), World Health Organization (WHO) histological classification (P < 0.001), and postoperative radiotherapy after initial resection (P = 0.006) were associated with recurrence (52/307, 16.9%). Multivariate analysis revealed that, after initial resection, WHO histological classification and Masaoka stage were independent predictors of DFS and OS. The pleura (25/52, 48.0%) were the most common site of recurrence, and locoregional recurrence (41/52, 79.0%) was the most common recurrence pattern. The recurrence pattern was an independent predictor of post-recurrence survival. Patients with recurrent thymoma who underwent repeated resec-tion had increased post-recurrence survival rates compared with those who underwent therapies other than surgery (P = 0.017). Conclusions: Masaoka stage and WHO histological classification were independent prognostic factors of thymoma after initial complete resection. The recurrence pattern was an independent predictor of post-recurrence survival. Locoregional recurrence and repeated resection of the recurrent tumor were associated with favorable prognosis.
  • 摘要：Background: The prognostic role of the V600E mutation of v-raf murine sarcoma viral oncogene homolog B1 (BRAF) in metastatic colorectal cancer (mCRC) is well established, but the therapeutic regimen targeting this disease is lack-ing. This study aimed to analyze the clinicopathologic features of and treatment efficacy of commonly used regimens on BRAF-mutated mCRCs. Methods: We collected and reviewed the medical records of mCRC patients treated at Peking University Cancer Hos-pital & Institute (Beijing, China) between July 2011 and July 2016. Kirsten rat sarcoma viral oncogene homolog (KRAS), neuroblastomaRAS viral oncogene homolog (NRAS), andBRAF mutational status was assayed using direct sequenc-ing. The details of clinicopathologic characteristics of patients and their responses to FOLFOXIRI regimen or standard therapy were obtained by reviewing the medical records. The progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan–Meier analysis and compared using the log-rank test. Results: Of 1694 patients studied, 75 had BRAF exon 15 mutations. Of these 75 patients, 71 had V600E mutation, 1 had D594G mutation, 2 had K601E mutation, and 1 had a novel T599_V600insAGA alteration. No patients had KRAS or NRAS mutations. Of 63 patients with BRAF V600E-mutated mCRC and sufficient clinical data, 27 (42.9％) had right-sided colon tumors, 19 (30.2％) had left-sided colon tumors, and 17 (26.9％) had rectal tumors; 26 (41.3％) had peritoneal metastases, and 50 (79.4％) had distant lymph node metastases. The patients withBRAF K601E- and T599_V600in-sAGA-mutated tumors had similar clinicopathologic features to those with BRAF V600E-mutated tumors. Patients with the BRAF V600E mutation benefited more from FOLFOXIRI regimen compared with patients who underwent standard therapy (overall response rate 83.3％ vs. 14.0％; median PFS 6.4 months vs. 2.8 months,P= 0.220; median OS 11.0 months vs. 6.9 months,P= 0.048). Conclusions:BRAF V600E mutations were commonly identified in right-sided tumors and showed a high incidence of peritoneal and distant lymph nodes metastases. This subtype of mCRC was characterized by short OS and unique patterns of metastasis. Compared with standard treatment regimens, the FOLFOXIRI regimen had acceptable and manageable toxicities and favorable efficacy on patients with BRAF-mutated mCRC.

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