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Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.

The standard sextant protocol failed to detect a large proportion of cancers located laterally in the peripheral zone. A 10 core biopsy regimen that combined laterally directed cores at the base, mid gland and apex of the prostate with mid lobar biopsy cores at the base and apex maximizes the sensitivity of transrectal ultrasound guided systematic biopsy.

BackgroundThe prognosis of most hepatocellular carcinoma (HCC) patients is poor due to the high metastatic rate of the disease. Understanding the molecular mechanisms underlying HCC metastasis is extremely urgent. The role of CD24 and NDRG2 (N-myc downstream-regulated gene 2), a candidate tumor suppressor gene, has not yet been explored in HCC.MethodsThe mRNA and protein expression of CD24 and NDRG2 was analyzed in MHCC97H, Huh7 and L-02 cells. Changes in cell adhesion, migration and invasion were detected by up- or down-regulating NDRG2 by adenovirus or siRNA. The expression pattern of NDRG2 and CD24 in HCC tissues and the relationship between NDRG2 and HCC clinical features was analyzed by immunohistochemical and western blotting analysis.ResultsNDRG2 expression was negatively correlated with malignancy in HCC. NDRG2 exerted anti-tumor activity by regulating CD24, a molecule that mediates cell-cell interaction, tumor proliferation and adhesion. NDRG2 up-regulation decreased CD24 expression and cell adhesion, migration and invasion. By contrast, NDRG2 down-regulation enhanced CD24 expression and cell adhesion, migration and invasion. Immunohistochemical analysis of 50 human HCC clinical specimens showed a strong correlation between NDRG2 down-regulation and CD24 overexpression (P = 0.04). In addition, increased frequency of NDRG2 down-regulation was observed in patients with elevated AFP serum level (P = 0.006), late TNM stage (P = 0.009), poor differentiation grade (P = 0.002), tumor invasion (P = 0.004) and recurrence (P = 0.024).ConclusionsOur findings indicate that NDRG2 and CD24 regulate HCC adhesion, migration and invasion. The expression level of NDRG2 is closely related to the clinical features of HCC. Thus, NDRG2 plays an important physiological role in HCC metastasis.

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The standard sextant protocol failed to detect a large proportion of cancers located laterally in the peripheral zone. A 10 core biopsy regimen that combined laterally directed cores at the base, mid gland and apex of the prostate with mid lobar biopsy cores at the base and apex maximizes the sensitivity of transrectal ultrasound guided systematic biopsy.

3-74 m). 121 (77.5%) had local control and progression occurred in 22.5%. 86 fiducial markers were placed in the liver with a 2.4% complications rate (grade 1-2). Local control (LC) at 1, 2 and 3 years was 93%, 81% and 64%. Univariate analyses showed a better LC for lesions < 5 cm (pZ0.001, HRZ0,26) and BED 10Gy 100 Gy (p<0.021). Median OS (OS) was 62 months. Actuarial OS at 1, 2, 3 and 5 years was 98%, 90%, 80% and 54% respectively. 4.5% of acute toxicity grade I (transient transaminitis) was reported. Late toxicity grade 3 was reported in 1 patient (1.5%) and grade 4 in another patient (1.5%). 68 patients were treated of 106 lung metastases (33.8% with 3 lesions); median follow-up was 18 months (3-67 m). 88 fiducial markers were placed guided by CT with a pneumothorax rate of 26,4% (18 patients), 7 were treated successfully with a drainage. 91.8% of the lesions achieved LC and progression occurred in 8.2%. The local control at 1,2 and 3 years was 94%, 92% and 85%. Univariate analyses showed better LC in lesions < 3 cm (pZ0.018, HRZ6.4) and BED 10Gy 132 Gy (p<0.005). Median OS was 59 months. Actuarial OS at 1, 2 , 3 and 5 years was 96%, 91%, 79%, and 49.6% respectively. 4.5% of acute toxicity grade I and 2.9% of late toxicity grade 3 was reported. Conclusion: Our clinical experience shows that SBRT with intrafraction control of tumor motion guided by internal fiducials and a Gating technique is a very safe and efficient treatment for patients with lung and liver metastases. The results in terms of toxicity and local control are excellent with a very promising long survival for these patients at 3 and 5 years.

We performed a meta-analysis of CD133-related clinical data to investigate the role of cancer stem cells (CSCs) in the clinical outcomes of colorectal cancer (CRC) patients, analyzing the effectiveness of various therapeutic strategies and examining the validity of the CSC hypothesis. For 28 studies (4546 patients), the relative risk (RR) to survival outcomes associated with CD133+ CRCs were calculated using STATA 12.0 software. Pooled results showed that CD133High patients had poor 5-year overall survival (RR 0.713, 95% CI 0·616–0·826) and 5-year disease free survival (RR 0·707, 95% CI 0·602–0·831). Both associations were consistently observed across different races, research techniques and therapeutic strategies. In a subgroup receiving adjuvant therapy, CD133Low patients achieved significantly better survival than CD133High patients. The findings suggest that CD133 could serve as a predictive marker of poor prognosis and treatment failure in CRC. CD133Low patients could benefit from adjuvant treatments, while CD133High patients should be given novel treatments besides adjuvant therapy. Our results also provide evidence in support of the CSC hypothesis.