简介：Baseduponstudiesfromrandomizedclinicaltrials,theextended(D2)lymphnodedissectionisnowrecommendedasastandardprocedureforlocaladvancedgastriccancerworldwide.However,therationalextentlymphadenectomyforlocaladvancedgastriccancerhasremainedatopicofdebateinthepastdecades.Duetothelimitationoflowmetastaticrateinpara-aorticnodes(PAN)inJCOG9501,theclinicalbenefitofD2+para-aorticnodaldissection(PAND)forpatientswithstageT4and/orstageN3disease,whichisverycommoninChinaandothercountriesexceptJapanandKorea,cannotbedetermined.Furthermore,theroleofsplenectomyforcompleteresectionofNo.10andNo.11nodeshasbeencontroversial,andhowever,thefinalresultsfromtherandomizedtrialofJCOG0110haveyettobecompleted.GastriccancerwiththeNo.14andNo.13lymphnodemetastasisisdefinedasM1stageinthecurrentversionoftheJapaneseclassification.WeproposethatD2+No.14vand+No.13lymphadenectomymaybeanoptioninapotentiallycurativegastrectomyfortumorswithapparentmetastasistotheNo.6nodesorinfiltratetoduodenum.Theexaminedlymphnodeandextranodalmetastasisaresignificantlyassociatedwiththesurvivalofgastriccancerpatients.

简介：Objective:Previousworkindicatedthataneuploidyofchromosome8incirculatingtumorcells(CTCs)correlatedwiththerapeuticefficacyforadvancedgastriccancer(AGC)patients.Inthisfollow-upstudyperformedonthesamepopulationofAGCpatients,weinvestigatedwhetherandhowaneuploidyofchromosome8inCTCscorrelateswithpatients'clinicalprognosis.Methods:Theprospectivestudywasperformedon31patientswithnewlydiagnosedAGC.Previouslyestablishedintegratedsubtractionenrichment(SE)andimmunostaining-fluorescenceinsituhybridization(iFISH)platformwasappliedtoidentify,enumerateandcharacterizeCTCs.QuantificationofCTCsandanalysisoftheiraneuploidyofchromosome8wereperformedonpatientsbeforeandaftertherapy.Results:CTCsweremeasuredin93.5%ofAGCpatients,andtwoCTCsubtypeswithdiversethresholdvalueswereidentified,multiploidCTCswiththethresholdof≥2per7.5mLandmultiploidplustriploidCTCswiththethresholdof≥4,whichwerefoundtosignificantlycorrelatewithpoorprogression-freesurvival(PFS)andoverallsurvival(OS).Inparticular,patientswith≥10%increasedmultiploidCTCsafteraninitial6weeksoftherapyhadpoorPFSandOS,whereasimprovedPFSandOSwereobservedonthosewhohad≥10%decreasedmultiploidCTCs.Afteradjustingforclinicallysignificantfactors,≥10%increasedpost-therapymultiploidCTCswastheonlyindependentpredictorofPFSandOS.Conclusions:AneuploidyofCTCscorrelateswithprognosisofAGCpatients.QuantitativecomparisonmonitoringmultiploidCTCsbeforeandaftertherapymayhelppredictimprovedorinferiorprognosisandchemoresistance.

简介：Objective:Theaimofthisprospective,single-armphaseIItrialwastoconfirmthesafetyandefficacyofneoadjuvantchemotherapy(NAC)usingoxaliplatinpluscapecitabine(CapOX)forpatientswithoperablelocallyadvancedcoloncancer(CC).Methods:Patientswithcomputedtomography-definedT4orlymphnode-positiveCCswereenrolled.Afterradiologicalstaging,patientsweretreatedwithatleast2cyclesofNACconsistingof130mg/m2oxaliplatinond1,plus1,000mg/m2capecitabinetwicedailyfor14devery3weeks,followedbysurgery,andthenwiththerestcyclesofadjuvantchemotherapy.Radiologicalresponsewasevaluatedafter2cyclesofNAC.Tumorresponse,treatmenttoxicity,andsurgicalcomplicationswererecorded.Thepathologicalresponsetotherapywasevaluatedaccordingtothetumorregressiongrade(TRG)score.Theprimaryendpointwaspathologictumorresponse.ThistrialisregisteredinClinicalTrials.gov(No:NCT02415829).Results:Forty-sevenpatientswereenrolledinthestudy.Forty-twopatientscompletedtheplannedtreatments.Thetotalradiologicalresponseratewas68%(32/47),includingcompleteandpartialresponseratesof2%(1/47)and66%(31/47),respectively.Stablediseasewasobservedin32%(15/47)andprogressivediseasewasobservedinnone.Completepathologicresponse,majorregression,andatleastmoderateregressionwereachievedin1(2%),2(4%),and29(62%)patients,respectively.Fourpatientsdevelopedgrade3treatmenttoxicities.Onepatientwithwoundinfectionoccurredafteroperation(1/47,2%).Therewasnotreatment-relateddeath.Conclusions:OurresultssuggestthatNACwithCapOXisaneffectiveandsafetreatmentoptionforpatientswithlocallyadvancedCCs.