Aim To investigate treatment patterns and outcomes of metastatic colorectal cancer (mCRC) patients beyond second progression (PD2) since regorafenib and TAS‐102 became available in Hong Kong. Methods The clinical records of consecutive mCRC patients who were treated beyond PD2 at Department of Clinical Oncology, Queen Mary Hospital between June 2013 and February 2018, were retrospectively reviewed. Results Of 176 PD2 patients (76.7% Eastern Cooperative Oncology Group performance status 0/1 and a median follow‐up time of 6.6 [range, 0.4–37.2] months), 104 (59%) underwent palliative care only and 72 (41%) received active third‐line (3L) treatment: regorafenib (n = 22), TAS‐102 (n = 6), chemotherapy + antiepidermal growth factor receptor (n = 12), chemotherapy + antivascular endothelial growth factor (n = 28) or clinical trials (n = 4). Patients on active 3L treatment had significantly longer OS than those on palliative care only: 11.7 versus 5.5 months (adjusted hazard ratio = 0.41, 95% confidence interval: 0.28–0.61, P < 0.001). For those on active treatment, OS was significantly associated with the time from diagnosis of metastasis to PD2 (P < 0.001) and post‐3L treatments (P = 0.009). When analyzing treatment eligibility according to trial criteria, half of the eligible patients (54/109) did not receive active treatment, but both eligible and ineligible patients achieved better OS when receiving active 3L treatment versus palliative care only (P < 0.001 and P = 0.002). No unexpected toxicity was reported. Conclusion Active 3L and beyond treatment significantly prolonged OS versus palliative care, even in selected “trial ineligible” patients. Given a high rate of palliation only care in eligible patients, improved patient access to medicine and counseling may be needed to maximize outcomes.

Enantioselective syntheses Enantioselective syntheses O 0031Catalytic Asymmetric Epoxidation of Alkenes with Arabinose-Derived Uloses.-Four L-erythro-2-uloses such as (I) are prepared and applied as catalysts in the epoxidation of trans-stilbene using Oxone as oxidant. Compounds (I) exhibit good enantioselectivities (up to 90% e.e.) but give only poor yields due to decomposition of the uloses during the reaction. Three L-threo-3-uloses such as (II) are not decomposed under epoxidation conditions and higher yields but lower enantioselectivities are obtained. (II) give moderate enantioselectivities and good yields in epoxidations of di-and trisubstituted alkenes.

The Uterine Fibroid Symptom and Health-related Quality of Life (UFS-QOL) questionnaire is a validated tool in English language to assess treatment outcomes for women with fibroids. We performed a Chinese (traditional) translation and cultural adaptation of it and evaluated its reliability, validity, and responsiveness. Methods: Overall, 223 Chinese women aged ≥18 years with uterine fibroids self-administered the UFS-QOL, Short-Form Health Survey-12, pictorial blood loss assessment chart (PBAC), and a visual analogue scale (VAS) on fibroid-related symptom severity. Demographics and haemoglobin levels were recorded; physical examination and ultrasound for size of fibroids were performed. Half of the women were followed up 6 months later for responsiveness. Results: Cronbach's alpha coefficients ranged from 0.706 to 0.937, demonstrating high internal reliability. The intra-class correlation coefficients to measure test-retest reliability implied excellent stability of symptom scores (0.819, P<0.001), healthrelated quality of life scores (0.897, P<0.001), and all subscales (range 0.721-0.870, P<0.001). Convergent validity was demonstrated by positive correlations

Due to the endoscopic screening, superficial esophageal cancer detection rate has been increasing and the rate of the patients with complex background such as superficially extended lesions, complications, history of other cancer, old age has been also increasing. For those patients, involved field radiation therapy is a good alternative. Treatment outcome of involved field irradiation for thoracic superficial esophageal squamous cell carcinoma in our hospital were retrospectively analyzed for future treatment strategies. Materials/Methods: From July 2003 to December 2014, 70 cases with T1N0M0 thoracic esophageal squamous cell carcinoma were treated with involved field radiation therapy and endoscopic evaluation after treatment. There were 61 male, 9 female, and the age ranged from 45 to 90 years old, with a median of 73 years old. Performance Status (PS) of all patients was 1 or better. The reasons for radiation therapy were comorbidities in 54 cases, broad-multiple lesions in 10 cases, and refuse of surgery in 6 cases. The invasion depths of the lesions were mucosal (M) in 25 cases and submucosal (SM) in 45 cases. Chemotherapy, mainly consisting of CDDP and 5FU, was concurrently used in 46 cases. Total doses were 50.4 Gy to 70 Gy with a median of 60 Gy (50.4 Gy in 7, 59.4 to 61.2 Gy in 51, 66 to 70 Gy in 12). Results: The follow up time ranged from 3 to146 months with a median of 36 months. The 2-years and 5-years crude survival rates were 95.7%, 88.3% in M cases and 89.6%, 78.3% in SM cases, respectively (P Z 0.769). The 2-years and 5-years recurrence-free survival rate were 89.4%, 82.5% in M cases and 83.0%, 52.0% in the SM cases, respectively. The SM cancer had been frequently recurred after 2 years. There were 20 recurrent cases, and 13 of them recurrent within radiation field, 1 recurred from field margin, 1 recurred in out of the field, 4 recurred in lymph node and 1 recurred in lung. The 9 of 13 in-field recurrences were salvaged by endoscopic resection, 8 of them were successfully salvaged, but 1 needed radical surgery. The 3 of 4 lymph nodes recurrence salvaged by radiation therapy. The one case of lung metastasis was successfully salvaged by video assisted thoracic surgery. Conclusion: There were few out-of-field recurrences and they were salvaged radiation therapy. The in-field recurrences were salvaged by endoscopic resection. Therefore, involved field radiation therapy seems to be a good treatment option for patients with comorbidities and old age. However, all lymph node recurrences occurred after 3 years, careful longterm follow-up must be necessary.