329 Background: We compared the efficacy and toxicity of gemcitabine with capecitabine (GX), and gemcitabine with erlotinib (GT) chemotherapy for recurrent or advanced pancreatic cancer by retrospective analysis. Methods: Between October 2006 and June 2010, 44 patients with recurrent or advanced pancreatic cancer, diagnosed at Seoul St. Mary's hospital were enrolled. In GT group, gemcitabine 1000mg/m2 was administered on days 1, 8, 15, 22, 29, 36, 43 followed by a 1-week rest in first treatment cycle (8 weeks), and then D1, 8, 15 followed by a 1-week rest. Erlotinib was taken orally at 150mg daily through the entire cycle. In GX group, gemcitabine 1000mg/m2 was administered on days 1 and 8. Capecitabine was taken orally at 650mg/m2 twice daily on day 1-14 of a 21-day cycle. Results: In 44 patients, 26 patients were treated with GT, and 18 patients treated with GX. The median age was 56.58 years in GT and 57.67 years in GX. Median number of cycle was 3.04 in GT and 3.57 in GX, and the dose reduction was significantly more common in GX than GT (50% vs. 19%, p=0.031). No complete response was achieved in either group. In GT, partial response and stable disease were achieved in 6 (23.1%) and 8 (30.8%) patients. In GX, partial response and stable disease were shown in 4 (22.2%) and 7 (38.9%) patients, respectively. No significant differences in two patients groups (p=0.442). GX had more favorable clinical outcome of the time to progression (6.1 months vs. 3.0 months, p=0.002) and the overall survival (11.13 months vs. 6.1 months, p=0.012) than GT. The most common grade 3 or 4 toxicity in GT and GX treatment were hematologic toxicity: anemia (8.3%:0%), neutropenia (34.6%:38.8%), thrombocytopenia (15.4%:11.1%). Grade 3 or 4 hand-foot-syndrome of GX was reported in only one patient. Conclusions: GX showed better time to progression and overall survival outcome than GT, but dose reduction was more common. Although there was no significant difference in response rate, and the less dose intensity, GX regimen may be more effective than GT in advanced pancreatic cancer. Further prospective, randomized trials would be warranted in large scale. No significant financial relationships to disclose.
management of metastatic colorectal cancer remains the best significantly improves overall 5-year survival. There are two wellapproaches of surgical treatment of patients with synchronous colorecsis. The former includes synchronous resection of the colorectal priresection of the liver metastases and the latter is a staged h. However, at present the issue of feasibility and effectiveness of ions for metastatic liver lesions in patients with synchronous metacancer (SMCLC) is negotiated and remains uncertain. This study the surgical outcomes and survival benefit between synchronous of the colorectal liver metastases. of 144 patients with colorectal cancer and synchronous liver metastases 2008-2017. There were two groups of patients. Fifty-eight A were undergone synchronous liver and colon resection whereas from group B -staged resection of colon and liver, respectively. 3-year survival in group A with synchronous resections was 41% and 50% (h>0.001). There were no significant differences in overall level of ons in the groups A and B after surgical stages finishing, and 36.1%(n ¼ 52), respectively (h>0.001). Shorter duration of the in the group A -316.3 (610.3) min in comparison with the 18.3) min (h<0.001). Patients after staged resection stayed longer in bed-days, then those who undergone synchronous resections -(p < 0.001) provided with shorter recovery terms in post-operative of our research has indicated necessity of the development of difch in SMCLC surgical treatment. Subsequent research should be study of prognosis factors and criteria for patients' selection for surgiassessment of economic efficacy and patients' life quality.
Background The purpose of the study was to compare the efficacy of two novel obesity indices, lipid accumulation product (LAP) and visceral adiposity index (VAI), with traditional obesity indices in predicting early-onset type 2 diabetes (T2DM). Methods In this cross-sectional study, a total of 744 participants, including 605 patients newly diagnosed with T2DM and 139 non-diabetic control subjects, were enrolled from a tertiary care hospital in Tianjin, China. Participants with T2DM were divided into two groups based on their age at diagnosis, namely early-onset T2DM (age less than 40 years, n = 154) and late-onset T2DM (age 40 years or older, n = 451). The predictive power of each obesity index was evaluated using receiver operating characteristic (ROC) curve analysis. Furthermore, binary logistic regression analysis was conducted to examine the independent relationship between LAP and VAI with early-onset T2DM risk. The relationship between novel obesity indices and the age of T2DM onset was also evaluated through correlation and multiple linear regression analysis. Results In males, LAP had the highest predictive power for early-onset T2DM with an area under the ROC curve (AUC) of 0.742 (95% CI 0.684–0.799, P < 0.001). In females, VAI had the highest AUC for early-onset T2DM with a value of 0.748 (95% CI 0.657–0.839, P < 0.001), which was superior to traditional indices. Patients in the 4th quartile of LAP and VAI had 2.257 (95% CI 1.116–4.563, P = 0.023) and 4.705 (95% CI 2.132–10.384, P < 0.001) times higher risk of T2DM before age 40, compared to those in the 1st quartile, respectively. A tenfold increase in LAP was associated with a decrease in T2DM onset age of 12.862 years in males (β = −12.862, P < 0.001) and 6.507 years in females (β = −6.507, P = 0.013). A similar decrease in T2DM onset age was observed for each tenfold increase in VAI in both male (β = −15.222, P < 0.001) and female (β = −12.511, P < 0.001) participants. Conclusions In young Chinese individuals, LAP and VAI are recommended over traditional obesity indices for improved prediction of early-onset T2DM risk.
Introduction: Hepatic hemangioma has incidence of 0.4% e 20% in general population and conventional ultrasound is often the first diagnostic method, normally as an incidental finding. Second generation contrast-enhanced ultrasound (CEUS) has been used in several areas of hepatology, with similar results on computed tomography and magnetic resonance imaging (MRI) in the diagnosis of hepatic hemangiomas. Objective: Correlation between the perflutren CEUS and MRI in the diagnosis of hepatic hemangiomas. Method: A prospective analysis of 37 patients with 57 nodules identified as incidental findings of routine ultrasound. In 37 patients, was administered perflutren contrast with no adverse effects. The 37 patients underwent MRI. Results: Conventional ultrasound identified nodules in 15 patients with typical characteristics of hemangiomas and 22 patients with nodules with other characteristics. In 35 patients the perflutren CEUS characteristics were compatible with hemangiomas. Correlation between ultrasound and MRI with contrast was 94.5%, and in discordant cases the diagnosis was made by MRI. In nodules with indeterminate characteristics on perflutren CEUS, MRI was repeated in three months, confirming the diagnosis of hepatic hemangioma. In the case with nodule suggestive of malignancy on perflutren CEUS we performed biopsy and confirmed the diagnostic of hepatic hemangioma. The ultrasound contrast advantages of greater access to population and lower costs in relation to MRI. Conclusion:We suggest a new protocol for liver nodules identified incidentally on conventional ultrasound. In typical hemangiomas, conventional ultrasound would suffice. In cases of non-typical nodules, perflutren CEUS confirms the diagnosis of hepatic hemangioma and closes the diagnostic investigation.
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