简介：AIM:Tostudyhowlymphnodemetastasis(LNM)riskisstratifiedinundifferentiated-typeearlygastriccancer(undiff-EGC)dependentoncombinationsofriskfactors.METHODS:Fivehundredandsixty-sevencaseswithundiff-EGCundergoinggastrectomywithlymphadenectomywereexaminedretrospectively.Usingclinicopathologicalfactorsofpatientage,location,size,anendoscopicmacroscopictumorform,ulceration,depth,histology,lymphaticinvolvement(LI)andvenousinvolvement(VI),LNMriskwasexaminedandstratifiedbyconventionalstatisticalanalysisanddatamininganalysis.RESULTS:LNMwaspositivein44of567cases(7.8%).Univariateanalysisrevealed>2cm,protrusion,submucosal(sm),mixedtype,LIandVIassignificantprognosticfactorsand>2cmandLI-positivewereindependentfactorsbymultivariateanalysis.InpreoperativelyevaluablefactorsexcludingLVI,smand>2cmwereindependentfactors.Accordingtothedepthandsize,caseswerecategorizedintothelow-riskgroup[mand≤2cm,0%(LNMincidence)],themoderateriskgroup(mand>2cm,5.6%;andsmand≤2cm,6.0%),andthehigh-riskgroup(smand>2cm,19.3%).Ontheotherhand,LNMoccurredin1.4%inallLI-negativecases,greatlylowerthan28.2%inallLI-positivecases,andLNMincidencewaslowinLInegativecaseseveninthemoderate-andhigh-riskgroups.CONCLUSION:LNM-relatedfactorsinundiff-EGCweredepthandsizepreoperativelywhilethosewereLIandsizepostoperatively.Amongthesefactors,LIwasthemostsignificantlycorrelatedfactor.

简介：AIMTocomparesurvivalandrecurrenceinhepatocellularcarcinoma（HCC）patientswhodidordidnotreceiveadjuvanttransarterialchemoembolization（TACE）.METHODS：Aconsecutivesampleof229patientswhounderwentcurativeresectionbetweenMarch2007andMarch2010inourhospitalwasincluded.Ofthese229patients,91（39.7%）underwentcurativeresectionfollowedbyadjuvantTACEand138（60.3%）underwentcurativeresectionalone.Inordertominimizeconfoundsduetobaselinedifferencesbetweenthetwopatientgroups,comparisonswereconductedbetweenpropensityscore-matchedpatients.SurvivaldataandrecurrencerateswerecomparedusingtheKaplan-Meiermethod.IndependentpredictorsofoverallsurvivalandrecurrencewereidentifiedusingCoxproportionalhazardregression.RESULTS：Among61pairsofpropensityscorematchedpatients,the1-,2-,and3-yearoverallsurvivalrateswere95.1%,86.7%,and76.4%intheTACEgroupand86.9%,78.5%,and73.2%inthecontrolgroup,respectively.Atthesametime,theTACEandcontrolgroupsalsoshowedsimilarrecurrenceratesat1year（13.4%vs24.8%）,2years（30.6%vs32.1%）,and3years（40.1%vs34.0%）.MultivariateCoxregressionidentifiedserumalpha-fetoproteinlevel≥400ng/mLandtumorsize〉5cmasindependentriskfactorsofmortality（P〈0.05）.CONCLUSION：AspostoperativeadjuvantTACEdoesnotimproveoverallsurvivalorreducerecurrenceinHCCpatients,furtherstudyisneededtoclarifyitsclinicalbenefit.

简介：AIMToinvestigatetheimpactofsurgicalproceduresonprognosisofgallbladdercancerpatientsclassifiedwiththelatesttumor-node-metastasis（TNM）stagingsystem.METHODS：Aretrospectivestudywasperformedbyreviewing152patientswithprimarygallbladdercarcinomatreatedatPekingUnionMedicalCollegeHospitalfromJanuary2003toJune2013.Postsurgicalfollow-upwasperformedbytelephoneandoutpatientvisits.ClinicalrecordswerereviewedandpatientsweregroupedbasedontheneweditionofTNMstagingsystem（AJCC,seventhedition,2010）.Prognoseswereanalyzedandcomparedbasedonsurgicaloperationsincludingsimplecholecystectomy,radicalcholecystectomy（orextendedradicalcholecystectomy）,andpalliativesurgery.Simplecholecystectomyis,bydefinition,resectionofthegallbladderfossa.Radicalcholecystectomyinvolvesawedgeresectionofthegallbladderfossawith2cmnonneoplasticlivertissue;resectionofasuprapancreaticsegmentoftheextrahepaticbileductandextendedportallymphnodedissectionmayalsobeconsideredbasedonthepatient＇scircumstance.Palliativesurgeryreferstocholecystectomywithbiliarydrainage.DataanalysiswasperformedwithSPSS19.0software.Kaplan-MeiersurvivalanalysisandLogranktestwereusedforsurvivalratecomparison.P〈0.05wasconsideredRESULTS：Patientsweregroupedbasedonthenew7theditionofTNMstagingsystem,including8casesofstage0,10casesofstageⅠ,25casesofstageⅡ,21casesofstageⅢA,21casesofstageⅢB,24casesofstageⅣA,43casesofstageⅣB.Simplecholecystectomywasperformedon28cases,radicalcholecystectomyorexpandedgallbladderradicalresectionon57cases,andpalliativeresectionon28cases.Thirty-ninecaseswerenotoperated.Patientswithstages0andⅠdiseasedemonstratednostatisticalsignificantdifferenceinsurvivaltimebetweenthosereceivingradicalcholecystectomyandsimplecholecystectomy（P=0.826）.TheprognosisofstageⅡpatientswithradicalcholecystect