BackgroundClinical prognostic parameters of liver metastasis from pancreatic adenocarcinoma have not been specifically identified.This study is to explore the risk factors of liver metastasis in advanced pancreatic adenocarcinoma (PDAC) patients in China.MethodsA multicenter cohort study was conducted to explore whether liver metastasis in locally advanced and metastatic PDAC could be reflected by some common laboratory indexes. We collected 1787 advanced PDAC patients from three participating hospitals between 2004 and 2014. The associations between some laboratory indexes and risks of liver metastases were analyzed.ResultsResults have shown that 87% of stage IV patients developed synchronous liver metastasis. Primary tumor location (body/tail vs. head/neck, OR 0.55, 95% CI 0.36-0.83), primary tumor diameter (≥20 mm vs. <20 mm, OR 1.77, 95% CI 1.16–2.70), elevated ALT and AST (OR 1.62, 95% CI 0.92–2.83), and elevated CA19-9 (OR 2.72, 95% CI 1.85–3.99) upon diagnosis are significantly associated with risk of synchronous liver metastasis. Among stage III patients, 30.1% developed metachronous liver metastasis. However, no risk factors were identified among these patients.ConclusionsPrimary tumor location, diameter, elevated ALT and AST, and increased CA19-9 are independent risk factors of synchronous liver metastasis in PDAC patients.
Cardiac MRI can determine viable myocardium and clearly delineate the location and degree of myocardial necrosis. PET slightly overestimates the extent of the necrotic myocardium and is unable to distinguish transmural necrosis from subendocardial necrosis.
Introduction: Comparison of side-to-side brachiocephalic arteriovenous fistula (BCAVF) with ligation of the perforating vein with end-to-side BCAVF. Report: All side-to-side with ligation of the perforating vein and end-to-side BCAVFs which were created in two hospitals were followed up to determine complications and patency rate of AVFs. Forty-four patients (24 side-to-side) entered the study but two patients censored from analysis due to early mortality. Patients of both groups were free of steal syndrome and venous hypertension. There were no significant differences in maturation time and complications between two groups. Respectively 2 and 3 failures occurred in side-to-side and end-to-side groups (P > 0.05). One year patency rate was 95% and 86% for side-to-side and end-to-side groups respectively. Discussion: Although there was no significant difference regarding primary and secondary access failure during follow up period, one year patency rate was higher in side-to-side group using life table analysis. Also, there was no significant difference regarding complications. This may show end-to-side BCAVF has no superiority to our new technique.
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