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  • 1
    Online Resource
    Online Resource
    Effect of Huaier granule on recurrence after curative resection of HCC: a multicentre, randomised clinical trial
    BMJ ; 2018
    In:  Gut Vol. 67, No. 11 ( 2018-11), p. 2006-2016
    Details
    In: Gut, BMJ, Vol. 67, No. 11 ( 2018-11), p. 2006-2016
    Abstract: There is little evidence that adjuvant therapy after radical surgical resection of hepatocellular carcinoma (HCC) improves recurrence-free survival (RFS) or overall survival (OS). We conducted a multicentre, randomised, controlled, phase IV trial evaluating the benefit of an aqueous extract of Trametes robinophila Murr (Huaier granule) to address this unmet need. Design and results A total of 1044 patients were randomised in 2:1 ratio to receive either Huaier or no further treatment (controls) for a maximum of 96 weeks. The primary endpoint was RFS. Secondary endpoints included OS and tumour extrahepatic recurrence rate (ERR). The Huaier (n=686) and control groups (n=316) had a mean RFS of 75.5 weeks and 68.5 weeks, respectively (HR 0.67; 95% CI 0.55 to 0.81). The difference in the RFS rate between Huaier and control groups was 62.39% and 49.05% (95% CI 6.74 to 19.94; p=0.0001); this led to an OS rate in the Huaier and control groups of 95.19% and 91.46%, respectively (95% CI 0.26 to 7.21; p=0.0207). The tumour ERR between Huaier and control groups was 8.60% and 13.61% (95% CI −12.59 to −2.50; p=0.0018), respectively. Conclusions This is the first nationwide multicentre study, involving 39 centres and 1044 patients, to prove the effectiveness of Huaier granule as adjuvant therapy for HCC after curative liver resection. It demonstrated a significant prolongation of RFS and reduced extrahepatic recurrence in Huaier group. Trial registration NCT01770431 ; Post-results.
    Type of Medium: Online Resource
    ISSN: 0017-5749 , 1468-3288
    URL: Article
    URL: Article
    DOI: 10.1136/gutjnl-2018-315983
    DOI: 10.1136/gutjnl-2018-315983.supp1
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2018
    detail.hit.zdb_id: 1492637-4
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  • 2
    Online Resource
    Online Resource
    Diagnosis and treatment of cholangiocarcinoma: A consensus from surgical specialists of China
    Springer Science and Business Media LLC ; 2014
    In:  Journal of Huazhong University of Science and Technology [Medical Sciences] Vol. 34, No. 4 ( 2014-8), p. 469-475
    Details
    In: Journal of Huazhong University of Science and Technology [Medical Sciences], Springer Science and Business Media LLC, Vol. 34, No. 4 ( 2014-8), p. 469-475
    Type of Medium: Online Resource
    ISSN: 1672-0733 , 1993-1352
    URL: Article
    DOI: 10.1007/s11596-014-1301-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2014
    detail.hit.zdb_id: 2376511-2
    detail.hit.zdb_id: 2931065-9
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  • 3
    Online Resource
    Online Resource
    Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2017 Edition)
    S. Karger AG ; 2018
    In:  Liver Cancer Vol. 7, No. 3 ( 2018), p. 235-260
    Details
    In: Liver Cancer, S. Karger AG, Vol. 7, No. 3 ( 2018), p. 235-260
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Hepatocellular carcinoma (HCC) (about 85–90% of primary liver cancer) is particularly prevalent in China because of the high prevalence of chronic hepatitis B infection. HCC is the fourth most common malignancy and the third leading cause of tumor-related deaths in China. It poses a significant threat to the life and health of Chinese people. 〈 b 〉 〈 i 〉 Summary: 〈 /i 〉 〈 /b 〉 This guideline presents official recommendations of the National Health and Family Planning Commission of the People’s Republic of China on the surveillance, diagnosis, staging, and treatment of HCC occurring in China. The guideline was written by more than 50 experts in the field of HCC in China (including liver surgeons, medical oncologists, hepatologists, interventional radiologists, and diagnostic radiologists) on the basis of recent evidence and expert opinions, balance of benefits and harms, cost-benefit strategies, and other clinical considerations. 〈 b 〉 〈 i 〉 Key Messages: 〈 /i 〉 〈 /b 〉 The guideline presents the Chinese staging system, and recommendations regarding patients with HCC in China to ensure optimum patient outcomes.
    Type of Medium: Online Resource
    ISSN: 2235-1795 , 1664-5553
    URL: Article
    DOI: 10.1159/000488035
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 2666925-0
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  • 4
    Online Resource
    Online Resource
    The individualized selection of Pancreaticoenteric anastomosis in Pancreaticoduodenectomy
    Springer Science and Business Media LLC ; 2020
    In:  BMC Surgery Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Surgery, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: The mortality following pancreaticoduodenectomy has markedly decreased but remains an important challenge for the complexity of operation and technical skills involved. The present study aimed to clarify the impact of individualized pancreaticoenteric anastomosis and management to postoperative pancreatic fistula. Methods Data from 529 consecutive pancreaticoduodenectomies were retrospectively analysed from the Hepatobiliary and Pancreatic Surgery Unit I, Peking Cancer Hospital. The pancreaticoenteric anastomosis was determined based on the pancreatic texture and diameter of the main pancreatic duct. The amylase value of the drainage fluid was dynamically monitored postoperatively on days 3, 5 and 7. A low speed intermittent irrigation was performed in selected patients. Intraoperative and postoperative results were collected and compared between the pancreaticogastrostomy (PG) group and pancreaticojejunostomy (PJ) group. Results From 2010 to 2019, 529 consecutive patients underwent pancreaticoduodenectomy. Pancreaticogastrostomy was performed in 364 patients; pancreaticojejunostomy was performed in 150 patients respectively. The clinically relevant pancreatic fistula (CR-POPF) was 9.8% and mortality was zero. The soft pancreas, diameter of main pancreatic duct≤3 mm, BMI ≥ 25, operation time  〉  330 min and pancreaticogastrostomy was correlated with postoperative pancreatic fistula significantly. The CR-POPF of PJ was significantly higher than that of PG in soft pancreas patients; the operation time of PJ was shorter than that of PG significantly in hard pancreas patients. Intraoperative blood loss and operation time of PG was less than that of PJ significantly in normal pancreatic duct patients ( p   〈  0.05). Conclusions Individualized pancreaticoenteric anastomosis should be determined based on the pancreatic texture and pancreatic duct diameter. The appropriate anastomosis and postoperative management could prevent mortality.
    Type of Medium: Online Resource
    ISSN: 1471-2482
    URL: Article
    DOI: 10.1186/s12893-020-00791-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2050442-1
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  • 5
    Online Resource
    Online Resource
    Characterization of genomic alterations in Chinese colorectal cancer patients with liver metastases
    Springer Science and Business Media LLC ; 2021
    In:  Journal of Translational Medicine Vol. 19, No. 1 ( 2021-12)
    Details
    In: Journal of Translational Medicine, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2021-12)
    Abstract: The exploration of genomic alterations in Chinese colorectal liver metastasis (CRLM) is limited, and corresponding genetic biomarkers for patient’s perioperative management are still lacking. This study aims to understand genome diversification and complexity that developed in CRLM. Methods A custom-designed IDT capture panel including 620 genes was performed in the Chinese CRLM cohort, which included 396 tumor samples from metastatic liver lesions together with 133 available paired primary tumors. Results In this Chinese CRLM cohort, the top-ranked recurrent mutated genes were TP53 (324/396, 82%), APC (302/396, 76%), KRAS (166/396, 42%), SMAD4 (54/396, 14%), FLG (52/396, 13%) and FBXW7 (43/396, 11%). A comparison of CRLM samples derived from left- and right-sided primary lesions confirmed that the difference in survival for patients with different primary tumor sites could be driven by variations in the transforming growth factor β (TGF-β), phosphatidylinositol 3-kinase (PI3K) and RAS signaling pathways. Certain genes had a higher variant rate in samples with metachronous CRLM than in samples with simultaneous metastasis. Overall, the metastasis and primary tumor samples displayed highly consistent genomic alterations, but there were some differences between individually paired metastases and primary tumors, which were mainly caused by copy number variations. Conclusion We provide a comprehensive depiction of the genomic alterations in Chinese patients with CRLM, providing a fundamental basis for further personalized therapy applications.
    Type of Medium: Online Resource
    ISSN: 1479-5876
    URL: Article
    DOI: 10.1186/s12967-021-02986-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2118570-0
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  • 6
    Online Resource
    Online Resource
    The prognostic impact of resection margin status varies according to the genetic and morphological evaluation (GAME) score for colorectal liver metastasis
    Wiley ; 2021
    In:  Journal of Surgical Oncology Vol. 124, No. 4 ( 2021-09), p. 619-626
    Details
    In: Journal of Surgical Oncology, Wiley, Vol. 124, No. 4 ( 2021-09), p. 619-626
    Abstract: Surgical margin status remains a controversial factor in predicting the outcome of colorectal liver metastases (CRLM) resection. Our study aims to evaluate the effects of surgical margins on oncologic outcomes with regard to the genetic and morphological evaluation (GAME) score. Methods R1 resection was defined as having a less than 1 mm margin width. Patients who underwent surgery for CRLM from January 2005 to December 2018 were recruited. The patients were divided into two risk subgroups, namely, the low or medium risk (GAME 0–3) and high‐risk (GAME score 4 or more) groups. The effects of margin status on overall survival (OS) and recurrence‐free survival rate (RFS) were examined. Results In total, 661 patients were recruited, among which 159 (24.1%) had R1 resection. Before hepatectomy, 514 patients showed a low or medium risk (R1 resection: n  = 124), while 147 patients demonstrated a high risk (R1 resection: n  = 35). In the whole cohort, multivariable analysis did show that R1 resection was associated with worse RFS and OS. While further research only found that in the low or medium risk group, R1 resection was related to poor OS and RFS. Meanwhile, in the high risk group, no significant difference was found in the median OS and RFS among patients with R0 or R1 resection. Conclusion The prognostic role of margin status varied according to the GAME score. Margin clearance only improved survival rates in patients with low or medium GAME score. In contrast, R1 resection demonstrated similar oncologic outcomes with R0 resection in patients with high GAME score.
    Type of Medium: Online Resource
    ISSN: 0022-4790 , 1096-9098
    URL: Issue
    URL: Article
    DOI: 10.1002/jso.v124.4
    DOI: 10.1002/jso.26557
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1475314-5
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  • 7
    Online Resource
    Online Resource
    Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis
    Springer Science and Business Media LLC ; 2020
    In:  World Journal of Surgical Oncology Vol. 18, No. 1 ( 2020-12)
    Details
    In: World Journal of Surgical Oncology, Springer Science and Business Media LLC, Vol. 18, No. 1 ( 2020-12)
    Abstract: Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients. Methods From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥ 70 years of age) were matched to 128 younger patients ( 〈  70 years of age) to obtain two balanced groups with regard to demographic, therapeutic, and prognostic factors. Results There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score III and comorbidities and lower proportion of more than 3 liver metastases and postoperative chemotherapy ( p   〈  0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175 ml vs. 200 ml, p  = 0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p  = 0.020), and a higher readmission rate (4.7% vs.0%, p  = 0.036). The EG also had longer disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant ( p   〉  0.05). Old age was not an independent factor for DFS, OS, and CSS by Cox multivariate regression analysis ( p   〉  0.05). Conclusions Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS, and CSS.
    Type of Medium: Online Resource
    ISSN: 1477-7819
    URL: Article
    DOI: 10.1186/s12957-020-02055-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2118383-1
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  • 8
    Online Resource
    Online Resource
    Irinotecan- vs oxaliplatin-based regimens for neoadjuvant chemotherapy in colorectal liver metastasis patients: A retrospective study
    Baishideng Publishing Group Inc. ; 2022
    In:  World Journal of Gastrointestinal Surgery Vol. 14, No. 9 ( 2022-9-27), p. 904-917
    Details
    In: World Journal of Gastrointestinal Surgery, Baishideng Publishing Group Inc., Vol. 14, No. 9 ( 2022-9-27), p. 904-917
    Type of Medium: Online Resource
    ISSN: 1948-9366
    URL: Article
    DOI: 10.4240/wjgs.v14.i9.904
    Language: Unknown
    Publisher: Baishideng Publishing Group Inc.
    Publication Date: 2022
    detail.hit.zdb_id: 2573700-4
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  • 9
    Online Resource
    Online Resource
    Five‐year survival post hepatectomy for colorectal liver metastases in a real‐world Chinese cohort: Recurrence patterns and prediction for potential cure
    Wiley ; 2023
    In:  Cancer Medicine Vol. 12, No. 8 ( 2023-04), p. 9559-9569
    Details
    In: Cancer Medicine, Wiley, Vol. 12, No. 8 ( 2023-04), p. 9559-9569
    Abstract: Patients with a 5‐year recurrence‐free survival post liver resection for colorectal cancer liver metastases (CRLM) are considered to be potentially cured. However, there is a deficit of data on long‐term follow‐up and the recurrence status among these patients in the Chinese population. We analyzed real‐world follow‐up data of patients with CRLM who underwent hepatectomy, explored the recurrence patterns, and established a prediction model for a potential cure scenario. Methods Patients who underwent radical hepatic resection for CRLM during 2000–2016, with actual follow‐up data for at least 5 years, were enrolled. The observed survival rate was calculated and compared among the groups with different recurrence patterns. The predictive factors for 5‐year non‐recurrence were determined using logistic regression analysis; a recurrence‐free survival model was developed to predict long‐term survival. Results A total of 433 patients were included, of whom 113 patients were found non‐recurrence after 5 years follow‐up, with a potential cure rate of 26.1%. Patients with late recurrence ( 〉 5 months) and lung relapse showed significantly superior survival. Repeated localized treatment significantly improved the long‐term survival of patients with intrahepatic or extrahepatic recurrences. Multivariate analysis showed that RAS wild‐type CRC, preoperative CEA 〈 10 ng/ml, and liver metastases ≤3 were independent factors for a 5‐year disease‐free recurrence. A cure model was developed based on the above factors, achieving good performance in predicting long‐term survival. Conclusions About one quarter patients with CRLM could achieve potential cure with non‐recurrence at 5‐year after surgery. The recurrence‐free cure model could well distinguish the long‐term survival, which would aid clinicians in determining the treatment strategy.
    Type of Medium: Online Resource
    ISSN: 2045-7634 , 2045-7634
    URL: Issue
    URL: Article
    DOI: 10.1002/cam4.v12.8
    DOI: 10.1002/cam4.5732
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2659751-2
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  • 10
    Online Resource
    Online Resource
    Hepatic resection provided long-term survival for patients with intermediate and advanced-stage resectable hepatocellular carcinoma
    Springer Science and Business Media LLC ; 2016
    In:  World Journal of Surgical Oncology Vol. 14, No. 1 ( 2016-12)
    Details
    In: World Journal of Surgical Oncology, Springer Science and Business Media LLC, Vol. 14, No. 1 ( 2016-12)
    Type of Medium: Online Resource
    ISSN: 1477-7819
    URL: Article
    DOI: 10.1186/s12957-016-0811-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2118383-1
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