Newmanhoover0916
One-stage local resection is recommended for the treatment of male patients with LGASC, but it is crucial to ensure that the margins are negative and postoperative adjuvant radiotherapy is not recommended.Background Low lymphatic tumor burden is associated with a better prognosis. However, it is uncertain whether those patients diagnosed as cN0 found to be pN+ could be a favorable subgroup in stage III disease. Radical surgery alone might avoid overtreatment in those patients. Methods Eligible patients diagnosed with colon cancer without metastasis were recruited from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2016 using SEER*Stat 8.3.5 software (Surveillance Research Program, National Cancer Institute) and divided into two groups surgery group (n = 3,081) and surgery followed by adjuvant chemotherapy group (n = 4,591). Overall survival (OS) and cause-specific survival (CSS) differences were assessed by Kaplan-Meier analysis, and survival differences were estimated with log-rank tests. Univariate and multivariate Cox proportional hazard regressions were used to assess hazard ratios (HRs) and 95% confidence intervals (CIs) for colon cancer patients. Results A total of 7,672 pT1-3N1a colon cancer patients were recruited from 208,751 colon cancer patients. The 5-year CSS rates of patients without and with adjuvant chemotherapy were 80.0 and 90.7%, respectively. The receipt of adjuvant chemotherapy after the radical resection of the primary tumor was independently associated with 57.3% decreased risk of colon cancer-specific mortality compared with surgery alone (HR = 0.427, 95% CI = 0.370-0.492, P less then 0.001, using surgery alone as the reference). Conclusions Adjuvant chemotherapy was significantly associated with improved prognosis and radical surgery alone did not provide enough treatment for colon cancer with very low lymphatic tumor burden.Background Both stereotactic body radiotherapy (SBRT) and radiofrequency ablation (RFA) are effective local treatments for hepatocellular carcinoma (HCC), but whether RFA is superior to SBRT is still controversial. Therefore, we performed a meta-analysis to compare the treatment outcomes of SBRT with RFA as curable or bridge intention. Methods We searched online databases for studies that compared treatment outcomes for SBRT and RFA. Sacituzumab govitecan molecular weight included evaluation of local control, overall survival (OS), transplant rate, and post-transplant pathological necrosis. Results As no randomized clinical trials met the criteria, 10 retrospective studies with a total of 2,732 patients were included. Two studies were in favor of SBRT in local control, two studies preferred RFA in OS, and others reported comparable outcomes for both. SBRT demonstrated significantly higher 1- and 3-year local control than RFA [odds ratio (OR) 0.42, 95% CI 0.24-0.74, P = 0.003; and OR 0.54, 95% CI 0.37-0.80, P = 0.002, respectively]. However, SBRT reported significantly shorter 1- and 2-year OS (OR 1.52, 95% CI 1.21-1.90, P = 0.0003; and OR 1.66, 95% CI 1.38-2.01, P less then 0.00001, respectively). As bridge treatment, no significant difference was shown in transplant rate and post-transplant pathological necrosis rate (OR 0.57, 95% CI 0.32-1.03, P = 0.060; and OR 0.49, 95% CI 0.13-1.82, P = 0.290, respectively). Conclusions This study demonstrates SBRT is able to complete a better local control for HCC than RFA, though the OS is inferior to RFA because of tumor burden or liver profiles of the enrolled studies. Well-designed, randomized, multicenter trials will be required to further investigate the conclusion.Objective To explore the distribution of Oncotype DX Breast Recurrence Score (RS), the proportion of receiving chemotherapy, and the relationship between RS and chemotherapy benefit according to detailed age groups in women with hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-negative (HR+/HER2-/N0) breast cancer. Methods This was an extensive, comprehensive, population-based retrospective study. Data on individuals with breast cancer were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program. The cohort was divided into five groups by age (≤ 35, 36-50, 51-65, 66-80, >80 years). RS distribution and chemotherapy proportion among different age groups were analyzed, and the overall survivals between patients receiving chemotherapy and those not/unknown were compared in each age group. Results The study cohort comprised 49,539 patients and the largest age group was 51-65 years. The percentage of patients with low-risk RS (0-10) increased with age, whereas those with intermediate-risk RS (11-25) decreased with age (except for the group of 36-50 years, which had the highest rate of intermediate-risk RS). #link# The age group ≤35 years has the greatest rate of high-risk RS (26-100). The proportion of receiving chemotherapy decreased with age in all RS risk categories. Overall survival was benefited by chemotherapy only in the age group of 66-80 years with intermediate- and high-risk RS, and chemotherapy seemed to do more harm than good for patients older than 80 years. Conclusions In the present study, we identified the distribution of RS, the proportion of receiving chemotherapy, and the relationship between RS and chemotherapy benefit according to a detailed age grouping for women with HR+/HER2-/N0 breast cancer, which may help in making individualized clinical decisions.Background This study outlines the unique modifications to surgical tracheostomy procedure to combat the extraordinary situation the world has found itself in due to COVID 19 pandemic. We explain the modifications employed to the operative setup, anesthetic considerations and surgical procedure to enable us to provide timely and safe tracheostomy to the COVID ICU patients requiring it, while simultaneously maximally protecting our surgical personnel from the deadly exposure. Methods- We conducted 55 surgical tracheostomies in severely sick ICU patients with the modifications deemed fit to achieve safe procedure for both the patient and the operating team. We analyzed the hospital record data of these patients and the surgical teams COVID 19 status to assesss the efficacy of our procedural modifications. Discussion- The COVID 19 pandemic has thrown the entire medical fraternity into a dilemma as to how to provide the best possible care to the patients while protecting ourselves from its grip. Severely sick COVID patients often require tracheostomy for improved prognosis.