简介：

简介：Objective:Differentiatedthyroidcarcinomas(DTCs)areclassifiedintopapillarythyroidcarcinoma(PTC)andfollicularthyroidcarcinoma(FTC).DTCsareanalyzedasasinglegroupinclinicalstudiesthatinvestigatedtheprognosticfactorsandprognosisofthesemalignancies.However,thebiologicalbehaviorsofthesecarcinomassignificantlydiffer.Inthepresentstudy,weaimedtodetectdifferencesintheoutcomesbetweenPTCandFTCinMansouraUniversityHospitalinEgypt.Methods:Atotalof558patientswithhistologicallyproventhyroidcarcinomasfromJanuary2003toDecember2012wereretrospectivelyenrolled.Theclinicalandpathologicaldataofpatientswerereviewed.Results:Largeprimarytumorsize,lymphnodeinvolvement,extrathyroidextension,anddistantmetastasisweresignificantpoorprognosticfactorsforoverallsurvival(OS)inoldPTCpatients.Coxhazardanalysisshowedthatthepatient'sage,extrathyroidextension,anddistantmetastasisweretheonlyindependentprognosticfactors.InFTCpatients,onlythedistantmetastasisanddegreeoftumorinvasionweresignificantpoorprognosticfactorsinOSunivariateanalysis.However,thesefactorswerenonsignificantinmultivariateanalysis.The10-yearOSrateswere97%and89%forPTCandFTC,respectively(P=0.003).The10-yeardisease-freesurvival(DFS)rateswere77.2%inPTCvs.65%inFTC(P=0.179).Conclusion:ThesignificantprognosticfactorsvarybetweenthetwotypesofDTCs.Therefore,PTCandFTCpatientsneedtobeanalyzedandreportedindependently.PTCsurvivaliswidelyandsignificantlyaffectedbyage,extrathyroidextension,anddistantmetastasis.Bycontrast,thesefactorswerenonsignificantinFTC,whichshowedpoorersurvivalthanPTC.

简介：

简介：Theabilitytomodulatethefutureliverremnant(FLR)isakeycomponentofmodernoncologichepatobiliarysurgerypracticeandhasextendedsurgicalcandidacyforpatientswhomayhavebeenpreviouslythoughtunabletosurviveliverresection.MultipletechniqueshavebeendevelopedtoaugmenttheFLRincludingportalveinembolization(PVE),associatingliverpartitionandportalveinligation(ALPPS),andtherecentlyreportedtranshepaticlivervenousdeprivation(LVD).PVEisawell-establishedmeanstoimprovethesafetyofliverresectionbyredirectingbloodflowtotheFLRinanefforttoselectivelyhypertrophyandultimatelyimprovefunctionalreserveoftheFLR.ThisarticlediscussesthecurrentpracticeofPVEwithfocusonsummarizingthelargenumberofpublishedreportsfromwhichoutcomesbasedpracticeshavebeendeveloped.BothtechnicalaspectsofPVEincludingvolumetry,approaches,andembolizationagents;andclinicalaspectsofPVEincludingdatasupportingindications,anditsroleinconjunctionwithchemotherapyandtransarterialembolizationwillbehighlighted.PVEremainsanimportantaspectofoncologiccare;inlargepartduetothesubstantialfoundationofinformationavailabledemonstratingitsclearclinicalbenefitforhepaticresectioncandidateswithsmallanticipatedFLRs.

简介：Objective:Epidermalgrowthfactorreceptor(EGFR)activationwasreportedtoupregulateprogrammeddeath-ligand1(PD-L1)expressioninlungcancercellsandsubsequentlycontributetoimmuneescape,indicatingitscriticalroleinEGFR-drivenlungtumors.ThisstudycharacterizedPD-L1expressioninpatientswithsurgicallyresectedEGFR-mutantnon-smallcelllungcancer(NSCLC).TheeffectofPD-L1expressiononclinicaloutcomeswasalsoinvestigatedinadvancedEGFR-mutantNSCLCtreatedwithEGFR-tyrosinekinaseinhibitors(TKIs).Methods:Intotal,73patientswithsurgicallyresectedNSCLCandEGFRmutationswereidentified.PD-L1expressionandCD8+tumor-infiltratinglymphocyte(TIL)densitywereassessedbyimmunohistochemistry.AliteraturereviewofpublicationsthatassessedthepredictiveandprognosticvalueofPD-L1expressioninadvancedEGFR-mutantNSCLCpatientstreatedwithEGFRTKIswasperformed.Results:Nineteen(26.0%)patientswerepositiveforPD-L1expression,whichwassignificantlyassociatedwithconcomitantKRASmutation(P=0.020)andmarginallyassociatedwithhigherCD8+TILsdensity(P=0.056).PositivePD-L1expressionwasassociatedwithmarkedlyinferioroverallsurvival(OS)inmultivariateanalysis(P=0.032).ThecombinationofPD-L1andCD8+TILsexpressioncouldbeusedtostratifythepopulationintothreegroupswithdistinctprognoses.Ameta-analysisofsixpublicationsshowedthatpositivePD-L1expressionwasnotassociatedwithOS[hazardratio(HR)=0.90;95%confidenceinterval(CI),0.42–1.38]orprogression-freesurvival(HR=1.03;95CI,0.73–1.33)inadvancedEGFR-mutantNSCLCpatientsreceivingEGFR-TKIs.Conclusions:PD-L1expressiontendedtocorrelatewithCD8+TILexpression,concomitantKRASmutation,andpoorsurvivalinsurgicallyresectedEGFR-mutantNSCLC.PD-L1expressionwasneitherthepredictivenortheprognosticfactorinadvancedEGFR-mutantNSCLCpatientstreatedwithEGFR-TKIs.

简介：