Objective To discuss the operative method and experience, through analyzing the medium-term and long-term effect of combined therapy for cutaneous squamous cancer of head and face. Methods From January 1998to December 2002, 37 patients with head or neck cutaneous squamous cancer received combined therapy of operation and radiation. The determination of resect area was based on the stage of the tumor, and according to the resect area and the freedom of peripheral tissue, 3 different operation procedures were adopted respectively. The follow-up was ended in June 2004. Results The follow-up was 5 to 69 months. The median follow-up interval was 38 months. Four patients (10.8%) relapsed during the follow-up, and 2 of them (5.4%) relapsed within 3 years after operation. two patients (5.4%) died from the primary affection, 4 patients (10.8%) died from other causes. According to Kaplan-Meier Method, the 3-year survival rate was 97.14% and the standard error was 0.0358, and 5-year survival rate was 92.28% and the standard error was 0.1047. Conclusion The recurrence rate of cutaneous squamous cancer of head and face witha better prognosis is lower than the ones from other origins. And the survival rate may be improved from proper operative method.
Objective To evaluate the security and outcomes of thoracolaparoscopic esophagectomy (TLE) versus open approach (OA) for thoracic esophageal squamous cell carcinoma. Methods From June 2014 to June 2015, 125 patients with thoracic esophageal squamous cell carcinoma underwent esophagectomy through McKeown approach, including TLE (a TLE group, 107 patients, 77 males and 30 females) and OA (an OA group, 18 patients, 13 males and 5 females). The data of operation and postoperative complications of the two groups were analyzed retrospectively. Results There was no statistical difference in the duration of operation and ICU stay and resected lymph nodes around laryngeal recurrent nerve between the TLE group and the OA group (333.58±72.84 min vs. 369.17±91.24 min, P=0.067; 2.84±1.44 d vs. 6.44±13.46 d, P=0.272; 4.71±3.87 vs. 3.89±3.97, P=0.408) . There was a statistical difference in blood loss, total resected lymph nodes and resected lymph nodes groups between TLE group and OA group (222.62±139.77 ml vs. 427.78±276.65, P=0.006; 19.62±9.61 vs. 14.61±8.07, P=0.038; 3.70±0.99 vs. 3.11±1.13, P=0.024). The rate of postoperative complications was 32.7% in the TLE group and 38.9% in the OA group (P=0.608). There was a statistical difference (P=0.011) in incidence of pulmonary infection (2.8% in the TLE group and 16.7% in the OA group). Incidences of complications, such as anastomotic leakage, cardiac complications, left-side hydrothorax, right-side pneumothorax, voice hoarse and incision infection, showed no statistical difference between two groups. Conclusion For patients with thoracic esophageal squamous cell carcinoma, TLE possesses advantages of more harvested lymph nodes, less blood loss and less pulmonary infection comparing with open approach, and is complied with the principles of security and oncological radicality of surgery.
Objective To explore the safety of minimally invasive esophagectomy (MIE) with three-field lymphadenectomy (3-FL) for esophageal squamous cell carcinoma (ESCC) by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy (2-FL) in MIE. Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively. Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method. And the clinical outcomes and postoperative complications were compared between the two groups. Results A total of 257 patients with ESCC were included in this study. There were 211 males and 46 females with an average age of 62.2±8.1 years. There were 109 patients in the 3-FL group and 148 patients in the 2-FL group. The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group (P<0.001). There was no statistical difference between the two groups in the intraoperatve blood loss (P=0.376). More lymph nodes (P<0.001) and also more positive lymph nodes (P=0.003) were obtained in the 3-FL group than in the 2-FL group, and there was a statistical difference in the pathological N stage between the two groups (P<0.001). But there was no statistical difference in the incidence of anastomotic leak (P=0.667), chyle leak (P=0.421), recurrent laryngeal nerve injury (P=0.081), pulmonary complications (P=0.601), pneumonia (P=0.061), cardiac complications (P=0.383), overall complications (P=0.147) or Clavien-Dindo grading (P=0.152) between the two groups. Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging, but it does not increase the postoperative complications, which is worthy of clinical application.
Objective To investigate the prognostic value of preoperative plasma fibrinogen (FIB) combined with lymphocyte-to-monocyte ratio (LMR) in predicting the prognosis of patients with esophageal squamous cell carcinoma. Methods A retrospective analysis was conducted on patients who underwent esophagectomy in our hospital from January 2015 to December 2018. Based on the cut-off values of preoperative FIB and LMR, The F-LMR scoring system was constructed, and patients were divided into three groups. Kaplan-Meier analysis was used to assess 5-year overall survival and 5-year progression free survival, and univariate and multivariate Cox regression analyses were performed to identify prognostic factors. Results Finally 260 patients were collected, including 237 males and 23 females, with a median age of 64 years (ranging from 59 to 70 years). The 5-year OS rates for patients with F-LMR score of 0, 1, and 2 were 24.44%, 51.69%, and 67.31%, respectively, and the 5-year PFS rates were 15.56%, 42.37%, and 57.62%, respectively. Lower preoperative F-LMR scores were associated with worse prognosis. Multivariate analysis showed that deeper tumor invasion, presence of lymph node metastasis, larger tumor maximum diameter, and lower preoperative F-LMR score were independent prognostic factors for OS. Conclusion The F-LMR score system based on the preoperative FIB and LMR can serve as an effective tool for predicting the prognosis of patients with esophageal squamous cell carcinoma.
ObjectiveTo evaluate the prognostic value of preoperative inflammatory indexes in patients with local-advanced esophageal squamous cell carcinoma.MethodsWe retrospectively analyzed the clinical and prognostic data of 150 local-advanced esophageal squamous cell carcinoma patients who were treated by esophagectomy in Guangyuan Central Hospital from July 2014 to July 2015. There were 128 males and 22 females with average age of 62.23±8.48 years. The optimal cutoff value was determined by receiver operation characteristics (ROC) curve analysis. Patients were grouped according to the optimal cutoff values (NLR=3.49, PLR=152.28, MLR=0.36). Log-rank test, and multivariate Cox logistic regression modelling were used to assess the simultaneous influences of prognostic factors for survival outcomes after esophagectomy.ResultsThe patients with higher ratio (NLR>3.49, PLR>152.28, MLR>0.36) had significantly shorter median progression free survival (PFS) and lower postoperative recurrent rate than those of the patients with lower ratio. The stratified analyses found that thelymph node staging and postoperative recurrent rate were positively correlated with the higher ratio. However, the tumor differentiation was negatively correlated with it. In univariate analyses, patients with preoperative NLR>3.49, PLR>152.28 and MLR>0.36 had a poorer prognosis. Furthermore, in multivariate analyses we found MLR>0.36 was also significantly associated with a decreased postoperative recurrent rate (HR=12.945, 95%CI 2.31 to 72.548, P=0.00).ConclusionsThe preoperative NLR, PLR and MLR are useful prognostic markers in patients with stage ⅢA-ⅣA esophageal squamous cell carcinoma who conducted esophagectomy.
目的总结原发性甲状腺鳞癌的诊治经验。方法回顾分析我院1996～2001年收治的12例原发性甲状腺鳞癌患者的临床资料。结果单纯性鳞癌4例，合并甲状腺其它疾病8例。主要临床表现为颈部包块和声嘶。单纯性鳞癌免疫组化甲状腺球蛋白染色阳性3例，阴性1例。12例患者中10例行姑息性切除者于术后1年内死亡，2例行根治性切除者存活时间超过3年。结论原发性甲状腺鳞癌呈高度恶性，可与甲状腺其它良、恶性疾病并存； 要重视对该病的诊断和鉴别诊断，免疫组化甲状腺球蛋白染色可提高确诊率； 根治性手术切除加综合治疗是提高其生存率的关键。
目的 探讨甲状腺鳞状细胞癌的临床特征和综合治疗效果。方法 回顾性分析1985年以来收治的4例原发性甲状腺鳞状细胞癌患者的临床资料。结果 单一手术的1例患者术后4个月死亡； 手术加放疗的2例患者术后6～13个月死亡； 手术加放、化疗的1例患者术后至今已两年仍存活。结论 甲状腺鳞状细胞癌系罕见的恶性肿瘤，生长速度快，术后易复发，预后差。早期行甲状腺癌联合根治术，并辅以放、化疗可降低复发机率，延长生存时间。