Publications by authors named "Li-Feng Yan"

96 Publications

Exploring the Coordination Modes of a Keggin-Type [ZnWO] Anionic Cluster: Bonding Patterns, Crystal Structure, and Semiconducting Properties.

Inorg Chem 2021 Jun 2. Epub 2021 Jun 2.

Key Laboratory of Polyoxometalate and Reticular Material Chemistry of Ministry of Education, Faculty of Chemistry, Northeast Normal University, Changchun, Jilin 130024, People's Republic of China.

Polyoxometalate-based organic-inorganic hybrid compounds (POIHCs) have been greatly developed due to their wide application prospects, but the pursuit of their directed synthesis via molecular design still remains a challenge. Herein, we demonstrate that the coordination modes of the Keggin-type [ZnWO] anion can be tuned, which leads to different semiconductor characteristics. Using the same building block, ligand, and metal ion (ZnW, phen, Cu), we synthesized three new POIHCs with different bonding patterns by means of different coordination modes of ZnW. The three POIHCs (Hphen){ZnWO[Cu(phen)]}·3HO (), {ZnWO[Cu(phen)(HO)][Cu(phen)(HO)]}·3HO (), and (MeN){ZnWO[Cu(phen)(HO)]}·5HO () (phen = 1,10-phenanthroline) have been structurally characterized by single-crystal X-ray diffraction. Compound appears as a zero-dimensional coordination complex cluster, while compounds and are both 1D chain structures with different Cu bridge linkages. Although these three POIHCs possess the same chemical components, their semiconductor properties are different, which is demonstrated by measurements of transient photocurrent and band gap () values. Furthermore, we carried out comparative experiments on the photoconductivity performance of compounds - and their photocatalytic reduction from O to HO, indicating the significant influence of the energy level matching on the photocatalytic activity.
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http://dx.doi.org/10.1021/acs.inorgchem.1c01098DOI Listing
June 2021

A Deep Learning Based Framework for Diagnosing Multiple Skin Diseases in a Clinical Environment.

Front Med (Lausanne) 2021 16;8:626369. Epub 2021 Apr 16.

Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Numerous studies have attempted to apply artificial intelligence (AI) in the dermatological field, mainly on the classification and segmentation of various dermatoses. However, researches under real clinical settings are scarce. This study was aimed to construct a novel framework based on deep learning trained by a dataset that represented the real clinical environment in a tertiary class hospital in China, for better adaptation of the AI application in clinical practice among Asian patients. Our dataset was composed of 13,603 dermatologist-labeled dermoscopic images, containing 14 categories of diseases, namely lichen planus (LP), rosacea (Rosa), viral warts (VW), acne vulgaris (AV), keloid and hypertrophic scar (KAHS), eczema and dermatitis (EAD), dermatofibroma (DF), seborrheic dermatitis (SD), seborrheic keratosis (SK), melanocytic nevus (MN), hemangioma (Hem), psoriasis (Pso), port wine stain (PWS), and basal cell carcinoma (BCC). In this study, we applied Google's EfficientNet-b4 with pre-trained weights on ImageNet as the backbone of our CNN architecture. The final fully-connected classification layer was replaced with 14 output neurons. We added seven auxiliary classifiers to each of the intermediate layer groups. The modified model was retrained with our dataset and implemented using Pytorch. We constructed saliency maps to visualize our network's attention area of input images for its prediction. To explore the visual characteristics of different clinical classes, we also examined the internal image features learned by the proposed framework using t-SNE (t-distributed Stochastic Neighbor Embedding). Test results showed that the proposed framework achieved a high level of classification performance with an overall accuracy of 0.948, a sensitivity of 0.934 and a specificity of 0.950. We also compared the performance of our algorithm with three most widely used CNN models which showed our model outperformed existing models with the highest area under curve (AUC) of 0.985. We further compared this model with 280 board-certificated dermatologists, and results showed a comparable performance level in an 8-class diagnostic task. The proposed framework retrained by the dataset that represented the real clinical environment in our department could accurately classify most common dermatoses that we encountered during outpatient practice including infectious and inflammatory dermatoses, benign and malignant cutaneous tumors.
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http://dx.doi.org/10.3389/fmed.2021.626369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085301PMC
April 2021

The Feature Ambiguity Mitigate Operator model helps improve bone fracture detection on X-ray radiograph.

Sci Rep 2021 Jan 15;11(1):1589. Epub 2021 Jan 15.

Department of Radiology, Third Hospital of Hebei Medical University, Hebei Province, Shijiazhuang, 050000, People's Republic of China.

This study was performed to propose a method, the Feature Ambiguity Mitigate Operator (FAMO) model, to mitigate feature ambiguity in bone fracture detection on radiographs of various body parts. A total of 9040 radiographic studies were extracted. These images were classified into several body part types including 1651 hand, 1302 wrist, 406 elbow, 696 shoulder, 1580 pelvic, 948 knee, 1180 ankle, and 1277 foot images. Instance segmentation was annotated by radiologists. The ResNext-101+FPN was employed as the baseline network structure and the FAMO model for processing. The proposed FAMO model and other ablative models were tested on a test set of 20% total radiographs in a balanced body part distribution. To the per-fracture extent, an AP (average precision) analysis was performed. For per-image and per-case, the sensitivity, specificity, and AUC (area under the receiver operating characteristic curve) were analyzed. At the per-fracture level, the controlled experiment set the baseline AP to 76.8% (95% CI: 76.1%, 77.4%), and the major experiment using FAMO as a preprocessor improved the AP to 77.4% (95% CI: 76.6%, 78.2%). At the per-image level, the sensitivity, specificity, and AUC were 61.9% (95% CI: 58.7%, 65.0%), 91.5% (95% CI: 89.5%, 93.3%), and 74.9% (95% CI: 74.1%, 75.7%), respectively, for the controlled experiment, and 64.5% (95% CI: 61.3%, 67.5%), 92.9% (95% CI: 91.0%, 94.5%), and 77.5% (95% CI: 76.5%, 78.5%), respectively, for the experiment with FAMO. At the per-case level, the sensitivity, specificity, and AUC were 74.9% (95% CI: 70.6%, 78.7%), 91.7%% (95% CI: 88.8%, 93.9%), and 85.7% (95% CI: 84.8%, 86.5%), respectively, for the controlled experiment, and 77.5% (95% CI: 73.3%, 81.1%), 93.4% (95% CI: 90.7%, 95.4%), and 86.5% (95% CI: 85.6%, 87.4%), respectively, for the experiment with FAMO. In conclusion, in bone fracture detection, FAMO is an effective preprocessor to enhance model performance by mitigating feature ambiguity in the network.
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http://dx.doi.org/10.1038/s41598-021-81236-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810849PMC
January 2021

Activating transcription factor 3 coordinates differentiation of cardiac and hematopoietic progenitors by regulating glucose metabolism.

Sci Adv 2020 May 6;6(19):eaay9466. Epub 2020 May 6.

CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200032, China.

The cardiac and hematopoietic progenitors (CPs and HPs, respectively) in the mesoderm ultimately form a well-organized circulation system, but mechanisms that reconcile their development remain elusive. We found that activating transcription factor 3 () was highly expressed in the CPs, HPs, and mesoderm, in zebrafish. The mutants exhibited atrial dilated cardiomyopathy and a high ratio of immature myeloid cells. These manifestations were primarily caused by the blockade of differentiation of both CPs and HPs within the anterior lateral plate mesoderm. Mechanistically, Atf3 targets to repress -mediated glucose utilization. The high rate of glucose metabolism in mutants inhibited the differentiation of progenitors by changing the redox state. Therefore, could provide CPs and HPs with metabolic adaptive capacity to changes in glucose levels. Our study provides new insights into the role of in the coordination of differentiation of CPs and HPs by regulating glucose metabolism.
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http://dx.doi.org/10.1126/sciadv.aay9466DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202888PMC
May 2020

Real-world impact of postmastectomy radiotherapy in T1-2 breast cancer with one to three positive lymph nodes.

Ann Transl Med 2020 Apr;8(7):489

Department of Radiation Oncology, the First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen 361003, China.

Background: The utility of postmastectomy radiotherapy (PMRT) in breast cancer patients with T1-2 (tumor size ≤5 cm) and N1 (one to three lymph nodes involved) disease remains controversial. The aim of this population-based study was to investigate the effectiveness of PMRT in this patient subset in the current clinical practice.

Methods: We included T1-2N1 breast cancer patients treated with mastectomy from 2004 to 2012 using the data form the Surveillance, Epidemiology, and End Results program. The association of PMRT administration with breast cancer-specific survival was determined using multivariable Cox analysis.

Results: We identified 10,248 patients of this study, including 3,725 (36.3%) received PMRT and 6,523 (63.7%) patients did not receive PMRT. Use of PMRT showed increase from 2008 onward; the percentage of patients receiving PMRT was 30.6% in 2004 and was 47.1% in 2012 (P<0.001). Patients diagnosis after 2008, aged <50 years, high tumor grade, T2 stage, and ≥2 positive lymph nodes were independently related to PMRT receipt. Multivariate analysis indicated that PMRT was not related to better breast cancer-specific survival compared to those without PMRT both before (P=0.186) and after propensity score matching (P=0.137).

Conclusions: In breast cancer with T1-2N1 disease, PMRT does not appear to improve survival in the era of modern systemic therapy.
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http://dx.doi.org/10.21037/atm.2020.03.49DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210210PMC
April 2020

From a blue to white to yellow emitter: a hexanuclear copper iodide nanocluster.

Dalton Trans 2020 May 20;49(18):5859-5868. Epub 2020 Apr 20.

Hubei Collaborative Innovation Center for Advanced Organic Chemical Materials, Ministry of Education Key Laboratory for the Synthesis and Application of Organic Functional Molecules, School of Chemistry and Chemical Engineering, Hubei University, Wuhan 430062, P. R. China.

Highly emissive copper(i) halide nanoclusters showing thermally activated delayed fluorescence (TADF) have been paid much attention, but rarely reported so far. Herein, a hexanuclear copper(i) iodide cluster containing a tridentate N∧P∧N ligand, [CuI(ppda)] {ppda = 2-[2-(dimethylamino)phenyl(phenyl)phosphino]-N,N-dimethylaniline}, was synthesized. All six copper atoms are four-coordinate, including four CuPNI and two CuI units. This complex exhibits intense white emission in the powder state at room temperature and shows a peak at a wavelength of 535 nm (Φ = 0.36) with a microsecond lifetime (τ = 4.4 μs). Emission colors can be largely tuned from blue to white to yellow, from the crystal to powder to film state at 297 K. The emission of [CuI(ppda)] originates from a combination of MLCT and XLCT transitions. This complex showed good thermal stability. A solution-processed, nondoped device of complex [CuI(ppda)] exhibits stable yellow emission with the CIE coordinates (x, y) of (0.43, 0.51). [CuI(ppda)] also shows reasonable photocatalytic H evolution activity under visible-light irradiation.
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http://dx.doi.org/10.1039/c9dt04701hDOI Listing
May 2020

Histological Tumor Type is Associated with One-Year Cause-Specific Survival in Women with Stage III-IV Epithelial Ovarian Cancer: A Surveillance, Epidemiology, and End Results (SEER) Database Population Study, 2004-2014.

Med Sci Monit 2020 Feb 2;26:e920531. Epub 2020 Feb 2.

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China (mainland).

BACKGROUND The prognosis of epithelial ovarian cancer (EOC) remains poor. Cause-specific survival (CSS) is an overall survival measure of cancer survival that excludes other causes of death. This retrospective population study used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate prognostic factors associated with one-year CSS in women with stage III-IV EOC between 2004-2014. MATERIAL AND METHODS Data from the SEER program included a cohort of patients with stage III-IV EOC between 2004-2014. Binomial logistic regression analysis, Kaplan-Meier survival curves, and multivariate Cox proportional hazards models were used for analysis of patient outcome, including the one-year CSS. RESULTS There were 14,798 patients with stage III-IV EOC identified from SEER between 2004-2014, including 13,134 (88.8%), 892 (6.0%), 448 (3.0%), and 324 (2.2%) patients with serous, endometrioid, clear cell, and mucinous ovarian cancer, respectively. The overall one-year CSS was 91.2%. One-year CSS was 92.5%, 92.2%, 74.0%, and 62.5% in patients with serous, endometrioid, clear cell, and mucinous ovarian cancer, respectively (P<0.001). Histological tumor type was an independent prognostic factor of one-year CSS. Patients with mucinous EOC (HR, 8.807; 95% CI, 6.563-9.965; P<0.001) and clear cell EOC (HR, 4.581; 95% CI, 3.774-5.560; P<0.001) had a significantly lower one-year CSS compared with patients with endometrioid and serous EOC who had comparable one-year CSS (HR, 1.247; 95% CI, 0.978-1.590; P=0.075). CONCLUSIONS A retrospective population study of the SEER database between 2004-2014 identified that histological tumor type was associated with one-year CSS in women with stage III-IV EOC.
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http://dx.doi.org/10.12659/MSM.920531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011572PMC
February 2020

Omission of adjuvant radiotherapy following breast-conserving surgery for elderly women with early-stage pure mucinous breast carcinoma.

Radiat Oncol 2019 Nov 4;14(1):190. Epub 2019 Nov 4.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.

Background: We aimed to ascertain population-based practice patterns and survival outcomes of postoperative radiotherapy following breast conserving-surgery (BCS) in elderly women (aged ≥65 years) with early-stage pure mucinous breast carcinoma (PMBC).

Methods: Patients aged ≥65 years diagnosed with T1-2N0 and hormone receptor-positive PMBC between 1990 and 2010 were identified from the Surveillance, Epidemiology, and End Results database. Binomial logistic regression, Kaplan-Meier method, Multivariate Cox proportional hazards models, and propensity score matching (PSM) were used for statistical analysis.

Results: We enrolled 3416 patients, including 1225 (35.9%) and 2191 (64.1%) in the no-radiotherapy and radiotherapy cohorts, respectively. The percentage of patients receiving postoperative radiotherapy following BCS was significantly lower after 2004 (59.5% between 2004 and 2010), relative to that before 2004 (71.1% between 1990 and 2003; P < 0.001). Before PSM, the 10-year breast cancer-specific survival (BCSS) rates were 98.1 and 93.2% for patients with and without postoperative radiotherapy (log-rank test, P < 0.001), respectively. In the PSM cohort, receiving postoperative radiotherapy was associated with better BCSS rates, with 10-year BCSS rates of 97.6 and 94.5% in patients with and without postoperative radiotherapy, respectively (log-rank test, P = 0.001). Multivariate Cox proportional analysis indicated that receiving postoperative radiotherapy was an independent factor associated with better BCSS before (P < 0.001) and after PSM (P = 0.001), relative to those not receiving postoperative radiotherapy.

Conclusions: This study shows a decreasing utilization of postoperative radiotherapy following BCS of elderly PMBC patients over time. However, postoperative radiotherapy following BCS should be administered for elderly women with PMBC owing to independent association with better survival.
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http://dx.doi.org/10.1186/s13014-019-1394-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829954PMC
November 2019

21-Gene Recurrence Score Assay Could Not Predict Benefit of Post-mastectomy Radiotherapy in T1-2 N1mic ER-Positive HER2-Negative Breast Cancer.

Front Oncol 2019 16;9:270. Epub 2019 Apr 16.

State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.

It is still controversial whether post-mastectomy radiotherapy (PMRT) is necessary for women with T1-2 N1mic ER-positive HER2-negative breast cancer. The 21-gene recurrence score (RS) assay has been validated in T1-2 N1 breast cancer to be prognostic of locoregional recurrence (LRR) and overall survival (OS). This study aims to evaluate the predict value of 21-gene recurrence score assay for the benefit of PMRT in T1-2 N1mic ER-positive HER2-negative breast cancer. A population-based cohort study was performed on women with T1-2 N1mic ER-positive HER2-negative breast cancer who underwent mastectomy and were evaluated using the 21-gene RS in the Surveillance, Epidemiology, and End Results (SEER) registry between 2004 and 2015. Clinical characteristics as well as OS and breast cancer-specific survival (BCSS) were compared between patients with and without PMRT in patients with a Low-, Intermediate-, and High-RS. Multivariate COX regression analysis was performed to investigate if the 21-gene RS assay could predict benefit of PMRT in this group of breast cancer patients. A total of 1571 patients met the criteria of our study and were enrolled, including 970 patients in the Low-Risk group (score <18), 508 in the Intermediate-Risk group (score 18-30), and 93 patients in the High-Risk group (score >30). In the High-Risk group, there were more patients with age ≥50 (87.0 vs. 64.3%, = 0.040) and received chemotherapy with a borderline significance (91.3 vs. 72.9%, = 0.066) in the PMRT subgroup than in the no PMRT subgroup. In all three groups, OS was comparable between the PMRT subgroup and the no PMRT subgroup. Furthermore, multivariate analysis did not show any OS benefit for PMRT based on the 21-gene recurrence score. This study showed that the 21-gene RS assay was not able to predict the benefit of PMRT for OS in women with T1-2 N1mic ER-positive HER2-negative breast cancer. However, further prospective larger sample-size trials are warranted to determine if a benefit exists.
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http://dx.doi.org/10.3389/fonc.2019.00270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477026PMC
April 2019

21-gene recurrence score and adjuvant chemotherapy decisions in patients with invasive lobular breast cancer.

Biomark Med 2019 02 19;13(2):83-93. Epub 2018 Dec 19.

Department of Radiation Oncology, Xiamen Cancer Hospital, the First Affiliated Hospital of Xiamen University, Xiamen 361003, PR China.

Aim: To determine the effect of the 21-gene recurrence score (RS) on outcome and chemotherapy decision in breast invasive lobular carcinoma (ILC).

Materials & Methods: We included 6467 patients with early stage and estrogen receptor-positive ILC from the Surveillance, epidemiology, and end results database.

Results: A total of 9.1, 31.4, and 70.1% of patients with low-, intermediate-, and high-risk RS groups received chemotherapy, respectively. A higher RS was independently associated with poor breast cancer-specific survival, and receipt of chemotherapy was not related to better breast cancer-specific survival in low-, intermediate-, or high-risk RS groups.

Conclusion: The 21-gene RS could impact chemotherapy decision making in early-stage ILC. However, adjuvant chemotherapy does not appear to improve outcome in high-risk RS cohort.
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http://dx.doi.org/10.2217/bmm-2018-0396DOI Listing
February 2019

Clinicopathologic characteristics and clinical outcomes of pure type and mixed type of tubular carcinoma of the breast: a single-institution cohort study.

Cancer Manag Res 2018 11;10:4509-4515. Epub 2018 Oct 11.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China,

Introduction: We aimed to evaluate the clinicopathologic characteristics and clinical outcomes of the mixed type versus the pure type of tubular carcinoma (TC) of the breast in a retrospective cohort study.

Materials And Methods: Patients were categorized into the following three groups: patients with pure TC of the breast (the PTC group), patients with TC and carcinoma in situ of the breast (the TC-CIS group), and patients with TC and other invasive carcinomas of the breast (the TC-IC group). We compared the clinicopathologic characteristics and treatment outcomes of the three groups. The primary end point of this study was breast cancer-specific survival (BCSS). Secondary end points included distant metastasis-free survival (DMFS) and locoregional recurrence (LRR).

Results: A total of 68 patients were included in this study, including 31 patients in the PTC group, 12 in the TC-CIS group, and 25 in the TC-IC group. Our data showed that PTC and TC-CIS were more likely to be smaller in size (=0.014) and had substantially less nodal involvement (=0.019), compared with TC-IC. The median follow-up time was 64.3 months (range, 3.78-223.2 months) for all patients. No locoregional relapse was observed in any group during the follow-up period. The 10-year BCSS of the PTC, TC-CIS, and TC-IC groups was 100%, 100%, and 95.2%, respectively, and the 10-year DMFS was 92.3%, 100%, and 96.0%, respectively. There was no significant difference in terms of BCSS (=0.53) or DMFS (=0.84) between the three groups.

Conclusion: This study indicates that both the pure type and mixed type of TC of the breast show very low LRR and distant metastasis rate and have excellent survival. The TC-IC group is likely to show good prognosis similar to the PTC group. Further clinical trials with larger sample sizes as well as molecular and genetic studies are warranted.
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http://dx.doi.org/10.2147/CMAR.S177046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6187920PMC
October 2018

Patterns of Distant Metastasis Between Histological Types in Esophageal Cancer.

Front Oncol 2018 8;8:302. Epub 2018 Aug 8.

State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.

Distant metastasis remains the major cause of treatment failure in esophageal cancer, though there have been few large-scale studies of the patterns of distant metastasis in different histological types. We investigated the patterns of distant metastasis in esophageal adenocarcinoma (AC) and squamous cell carcinoma (SCC) using a population-based approach. Patients with stage IV esophageal cancer at diagnosis were identified using the Surveillance, Epidemiology, and End Results database. Multivariable logistic regression was performed to identify potential risk factors for site-specific distant metastasis to the distant lymph nodes, bone, liver, brain, and lung at diagnosis. We identified 1,470 patients with complete data for analysis including 1,096 (74.6%) patients with AC and 374 (25.4%) patients with SCC. A total of 2,243 sites of distant metastasis were observed, the liver was the most common site of distant metastasis (727, 32.4%), followed by the distant lymph nodes (637, 28.4%), lung (459, 20.5%), bone (344, 15.3%), and brain (76, 3.4%). Multivariable logistic regression showed that compared to patients with SCC, patients with AC were more likely to have metastasis to the brain (odds ratio [OR] 3.026, 95% confidence interval [CI] 1.441-6.357, = 0.003) and liver (OR 1.848, 95% CI 1.394-2.451, < 0.001), and less likely to have metastasis to the lung (OR 0.404, 95% CI 0.316-0.516, < 0.001). Histological type had no effect on metastasis to the distant lymph nodes or bone. Patients with esophageal AC are more likely to present with liver and brain metastases, and less likely to present with lung metastasis than patients with esophageal SCC.
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http://dx.doi.org/10.3389/fonc.2018.00302DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092597PMC
August 2018

Long-term survival effect of the interval between mastectomy and radiotherapy in locally advanced breast cancer.

Cancer Manag Res 2018 16;10:2047-2054. Epub 2018 Jul 16.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China,

Introduction: The timing of postmastectomy radiotherapy (PMRT) may influence locoregional recurrence and survival outcomes. In this study, we assessed the long-term survival effect of the interval between surgery and PMRT in locally advanced breast cancer treated with mastectomy and adjuvant chemotherapy.

Methods: In this retrospective study, we included women with locally advanced breast cancer who underwent adjuvant chemotherapy and PMRT after mastectomy between 1999 and 2007. Based on the interval between surgery and PMRT, the patients were classified into three groups: Group 1 (≤4 vs >4 months), Group 2 (≤5 vs >5 months), and Group 3 (≤6 vs >6 months). Univariate and multivariate regression analyses were performed to determine the prognostic factors of survival outcomes.

Results: A total of 340 women were included in this study, and the median follow-up duration was 79.8 months. The median surgery-PMRT interval was 5 months. The surgery-PMRT interval including Group 1, Group 2, and Group 3 was not significantly associated with locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, and overall survival. In addition, in the subgroup analysis of the effect of surgery-PMRT interval on survival outcomes according to various clinicopathologic factors, the surgery-PMRT interval was also not associated with survival outcomes in different age groups, tumor stage, and breast cancer subtypes.

Conclusion: Our findings suggest that the delay in the start of PMRT in locally advanced breast cancer does not increase the likelihood of locoregional recurrence, distant metastasis, and death.
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http://dx.doi.org/10.2147/CMAR.S163863DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6053260PMC
July 2018

Tubular carcinomas of the breast: an epidemiologic study.

Future Oncol 2018 Dec 10;14(29):3037-3047. Epub 2018 Jul 10.

Department of Radiation Oncology, Xiamen Cancer Hospital, the First Affiliated Hospital of Xiamen University, Xiamen 361003, PR China.

Aim: We explored the clinicopathologic characteristics, prognostic factors and outcomes in tubular carcinoma (TC) of the breast.

Methods: We retrospectively assessed 8091 TC patients using the SEER database from 2000 to 2013.

Results: Most patients were non-Hispanic white, well-differentiated disease, tumor size ≤2 cm, node-negative, nonmetastatic, hormone receptor-positive and HER2-negative status. The 10-year breast cancer-specific survival and overall survival were 98.1 and 82.0%, respectively. Multivariate analysis indicated that age, ethnicity, surgery procedures, radiotherapy and chemotherapy were independent predictors affecting survival outcomes. There was comparable breast cancer-specific survival between surgery and nonsurgery groups.

Conclusion: The patients with TC has excellent survival outcomes, which may in part be due to the favorable tumor characteristics.
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http://dx.doi.org/10.2217/fon-2018-0385DOI Listing
December 2018

Omission of Postoperative Radiotherapy in Women Aged 65 Years or Older With Tubular Carcinoma of the Breast After Breast-Conserving Surgery.

Front Oncol 2018 30;8:190. Epub 2018 May 30.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.

Introduction: To investigate the temporal trends of postoperative radiotherapy (RT) administration and the effects of omitting postoperative RT on breast cancer-specific survival (BCSS) in women aged ≥65 years with tubular carcinoma (TC) of the breast who received breast-conserving surgery (BCS).

Methods: We included women aged 65 years with non-metastatic TC of the breast who underwent BCS between 2000 and 2013 using the Surveillance, Epidemiology, and End Results database. Statistical analyses were performed using chi-square tests, Kaplan-Meier analyses, Cox proportional hazards models, and a 1:1 propensity score matching (PSM).

Results: Before PSM, a total of 1,475 patients with tumor size ≤2 cm, node-negative disease, and estrogen receptor-positive disease were identified, including 927 (62.8%) underwent postoperative RT and 548 (37.2%) had postoperative omission of RT. The administration of postoperative RT steadily declined over the study period. Patients with younger age, larger tumor size, and other race/ethnicity were more likely to receive postoperative RT. The median follow-up duration was 85.0 months, the 5- and 10-year BCSS rates were 98.7 and 97.9%, respectively. The median BCSS was 161.9 and 165.0 months for patients with and without postoperative RT, respectively, and the corresponding 5-year BCSS rates were 98.5 and 98.8%, respectively ( = 0.134). Prognostic analysis indicated that postoperative RT was not associated with improved BCSS rates compared with RT omission ( = 0.134). After PSM, a total of 431 complete pairs were generated. In the matched population, the 5-year BCSS rates were 98.6 and 98.4% in non-postoperative RT and postoperative RT groups, respectively ( = 0.858). The univariate analyses also confirmed that the administration of postoperative RT was not associated with better BCSS ( = 0.858).

Conclusion: The incidence of breast cancer-related death is probably sufficiently low to avoid postoperative RT in women aged ≥65 years with TC of the breast after BCS.
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http://dx.doi.org/10.3389/fonc.2018.00190DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5988847PMC
May 2018

Lymph node ratio has prognostic value related to the number of positive lymph nodes in patients with vulvar cancer.

Future Oncol 2018 Oct 29;14(23):2343-2351. Epub 2018 May 29.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, PR China.

Aim: We investigated the value of the number of positive lymph nodes (PLNs) and lymph node ratio (LNR) on survival of vulvar cancer patients.

Methods: A total of 2332 patients with vulvar squamous cell carcinoma were included from the SEER program.

Results: In multivariate analysis, the number of PLNs and LNR were independent prognostic indictors of survival outcomes, a higher number of PLNs and a higher LNR had poorer survival outcomes. An LNR >0.2 was associated with poor survival outcomes according to the number of PLNs.

Conclusion: The LNR has prognostic value related to the number of PLNs and may allow a more accurate determination of the lymph node status of vulvar cancer patients.
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http://dx.doi.org/10.2217/fon-2018-0279DOI Listing
October 2018

Widowed status increases the risk of death in vulvar cancer.

Future Oncol 2018 Oct 10;14(25):2589-2598. Epub 2018 May 10.

Department of Obstetrics & Gynecology, the First Affiliated Hospital of Xiamen University, Xiamen 361003, PR China.

Aim: To evaluate the effect of marital status on survival of patients with vulvar cancer.

Materials & Methods: A total of 4001 patients with vulvar cancer were included from the SEER database. Statistical analyses were performed using χ test, Kaplan-Meier method, Cox regression proportional hazards and a 1:1 propensity score-matching.

Results: The 8-year vulvar cancer-related survival in married, divorced, single and widowed patients were 78.6, 82.2, 78.9 and 61.6%, respectively (p < 0.001). In multivariate analysis, widows patients had significantly worse vulvar cancer survival than the nonwidowed counterparts in unmatched and matched populations.

Conclusion: Being widowed is associated with greater risk of vulvar cancer mortality than the nonwidowed counterparts.
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http://dx.doi.org/10.2217/fon-2018-0255DOI Listing
October 2018

The Clinicopathological Features and Survival Outcomes of Different Histological Subtypes in Triple-negative Breast Cancer.

J Cancer 2018 1;9(2):296-303. Epub 2018 Jan 1.

Department of Radiation Oncology, Xiamen Cancer Hospital, the First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China.

To determine the clinicopathological features and survival outcomes of triple-negative breast cancer (TNBC) according to different histological subtypes. Using the Surveillance, Epidemiology, and End Results database, we included TNBC cases in 2010-2013. The effect of histological subtype on breast cancer-specific survival (BCSS) and overall survival (OS) were analyzed using univariate and multivariate analyses. A total of 19,900 patients were identified. Infiltrating ductal carcinoma not otherwise specified accounted for 91.6% of patients, followed by metaplastic carcinoma (2.7%), medullary carcinoma (1.4%), mixed lobular-ductal carcinoma (1.4%), lobular carcinoma (1.3%), apocrine carcinoma (1.0%), and adenoid cystic carcinoma (0.6%). Medullary carcinoma was more frequently poorly/undifferentiated. Significantly more lobular carcinoma, mixed lobular-ductal carcinoma, and metaplastic carcinoma patients had larger tumors. Adenoid cystic carcinoma, metaplastic carcinoma, medullary carcinoma, and apocrine carcinoma were more frequently node-negative. Lobular carcinoma (16.0%) and mixed lobular-ductal carcinoma (10.4%) more frequently had distant stage at initial diagnosis. Histologic subtype was an independent prognostic factor of BCSS and OS. Compared with infiltrating ductal carcinoma, medullary carcinoma and apocrine carcinoma had better BCSS and OS, while mixed lobular-ductal carcinoma and metaplastic carcinoma had worse survival. Adenoid cystic carcinoma survival was not significantly different from that of infiltrating ductal carcinoma. TNBC histological subtypes have different clinicopathological characteristics and survival outcomes. Medullary carcinoma and apocrine adenocarcinoma have excellent prognosis; mixed lobular-ductal carcinoma and metaplastic carcinoma are the most aggressive subtypes.
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http://dx.doi.org/10.7150/jca.22280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771337PMC
January 2018

Survival in signet ring cell carcinoma varies based on primary tumor location: a Surveillance, Epidemiology, and End Results database analysis.

Expert Rev Gastroenterol Hepatol 2018 Feb 17;12(2):209-214. Epub 2017 Dec 17.

a Department of Radiation Oncology , Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University , Xiamen , People's Republic of China.

Background: The aim of this study was to investigate the survival of patients with signet ring cell carcinoma (SRCC) based on primary tumor location.

Methods: Patient data were obtained from the Surveillance, Epidemiology, and End Results database (1988-2012) with ≥200 cases per tumor location. Cox regression analysis was used to investigate prognostic factors of cause-specific survival (CSS).

Results: We identified 24,171 patients. Of the patients, 63.4% had gastric SRCC, followed by colon (18.2%), esophageal (5.0%), rectal (3.5%), lung (3.1%), pancreatic (1.8%), breast (1.5%), bladder (1.3%), small intestine (1.1%), and gallbladder SRCC (1.0%). The 5-year CSS was 22.1%, 69.0%, 33.2%, 28.1%, 24.8%, 16.1%, 13.6%, 12.6%, 11.0%, 6.4% in patients with gastric, breast, colon, rectum, bladder, small intestine, esophageal, gallbladder, lung, and pancreatic SRCC, respectively (P < 0.001). Multivariate analyses showed that the primary tumor location was an independent prognostic factor of survival. Patients with lung, small intestine, and bladder SRCC had a comparable CSS to gastric SRCC, while breast and colorectal SRCC had better survival than gastric SRCC. Esophageal, gallbladder, and pancreatic SRCC were significantly associated with poor CSS compared with gastric SRCC.

Conclusion: Our study suggests a major difference in survival of SRCC based on the primary tumor locations.
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http://dx.doi.org/10.1080/17474124.2018.1416291DOI Listing
February 2018

Comparable Survival between Additional Radiotherapy and Local Surgery in Occult Breast Cancer after Axillary Lymph Node Dissection: A Population-based Analysis.

J Cancer 2017 17;8(18):3849-3855. Epub 2017 Oct 17.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China.

To investigate the clinical value of additional local treatment strategies in occult breast cancer (OBC) after axillary lymph node dissection (ALND). Patients diagnosed with OBC between 1990 and 2013 were included from the Surveillance, Epidemiology, and End Results registry database. The significant risk factors of cause-specific survival (CSS) and overall survival (OS) were identified using univariate and multivariate Cox regression analyses. We identified 980 patients, including 219 (22.3%), 252 (25.7%), 263 (26.8%), and 246 (25.1%) of patients underwent ALND, ALND + radiotherapy (RT), ALND + surgery (S) (mastectomy or breast-conserving surgery), and ALND + S + RT, respectively. Patients with younger age, diagnosed before 2000, advanced nodal stage, ER-negative disease, and PR-negative disease were more likely to undergo additional local treatment compared with ALND only. The 10-year rate CSS of the ALND only group was 57.2%, while that of the ALND + RT, ALND + S, and ALND + S + RT groups was 78.0%, 81.0%, and 71.5%, respectively ( < 0.001). The 10-year OS rate in the ALND only, ALND + RT, ALND + S, and ALND + S + RT groups was 46.0%, 69.5%, 66.1%, and 67.0%, respectively ( < 0.001). Multivariate analysis indicated that older age, advanced nodal stage, and ALND only were independent risk factors for decreased CSS and OS. CSS and OS among the groups including ALND + RT, ALND + S, and ALND + S + RT were not significantly different. Additional local treatment (local surgery or RT) improves survival outcomes compared with ALND only in OBC after ALND. ALND + RT may be the optimal local treatment for OBC due to no different in survival outcomes and cosmesis is better.
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http://dx.doi.org/10.7150/jca.21217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688938PMC
October 2017

Postoperative radiotherapy for invasive micropapillary carcinoma of the breast: an analysis of Surveillance, Epidemiology, and End Results database.

Cancer Manag Res 2017 3;9:453-459. Epub 2017 Oct 3.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou.

Introduction: Invasive micropapillary carcinoma (IMPC) of the breast poses a high risk of locoregional recurrence, and postoperative radiotherapy (PORT) may be beneficial in IMPC. Hence, we determined the clinical value of PORT in IMPC patients.

Patients And Methods: We assessed clinicopathological factors extracted from the Surveillance, Epidemiology, and End Results database (2004-2013). Univariate and multivariate Cox proportional hazards regressions were performed to assess the independent prognostic factors on breast cancer-specific survival (BCSS) and overall survival (OS).

Results: Of the 881 study patients, 444 (50.4%) and 437 (49.6%) underwent breast-conserving surgery (BCS) and mastectomy (MAST), respectively, of whom 357 (80.4%) and 153 (35.0%) underwent PORT, respectively. Patients with young age, large tumor size, or advanced nodal stage were more likely to undergo MAST and PORT compared with MAST alone. Patients with progesterone receptor-positive disease were more likely to receive BCS and PORT compared with BCS alone. The 5-year BCSS and OS were 95.7% and 90.9%, respectively. On multivariate analyses, tumor size, histological grade, and estrogen receptor status were independent predictors of BCSS and OS. The types of surgical procedures (MAST vs. BCS) were not an independent predictor of survival outcomes. Patients who underwent MAST with or without PORT had similar BCSS and OS in the multivariate analyses. Those who underwent BCS plus PORT did not have better BCSS and OS than those who underwent BCS alone. In the low-, intermediate-, and high-risk groups, PORT was not associated with better BCSS and OS than non-PORT groups in patients who received BCS or MAST.

Conclusion: IMPC has favorable BCSS and OS. Regardless of the types of surgical procedures (MAST or BCS), PORT groups were not inferior to non-PORT groups on BCSS and OS.
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http://dx.doi.org/10.2147/CMAR.S141338DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635851PMC
October 2017

Multimodal treatment including hysterectomy improves survival in patients with locally advanced cervical cancer: A population-based, propensity score-matched analysis.

Int J Surg 2017 Dec 12;48:122-127. Epub 2017 Oct 12.

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China. Electronic address:

Background: To evaluate the therapeutic value of multimodal treatment including hysterectomy in locally advanced cervical squamous cell carcinoma (SCC).

Methods: We retrospectively reviewed patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIB-III cervical SCC and received chemotherapy and radiotherapy with or without hysterectomy between 2000 and 2013 using the Surveillance, Epidemiology, and End Results program. Propensity score-matching was used to balance baseline characteristics of included patients. Univariate and multivariate Cox regression analyses were performed to determine prognostic factors for cervical cancer specific-survival (CCSS) and overall survival (OS).

Results: We identified 2473 patients and 522 pairs of patients were completely matched with each other. In the unmatched population, patients with younger age, non-black race, poorly/undifferentiated disease, FIGO stage IIB disease, and node-positive disease were more likely to receive additional hysterectomy. Additional hysterectomy was associated with better CCSS and OS in unmatched and matched populations. Moreover, when evaluating the survival difference by FIGO stage, only stage IIB disease retained statistical significance but not for stage III disease in unmatched and matched populations.

Conclusions: Our results suggest that multimodal treatment including hysterectomy might improve survival outcomes in patients with locally advanced cervical SCC, especially for stage IIB disease.
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http://dx.doi.org/10.1016/j.ijsu.2017.10.028DOI Listing
December 2017

The survival benefits of local surgery in stage IV breast cancer are not affected by breast cancer subtypes: a population-based analysis.

Oncotarget 2017 Sep 29;8(40):67851-67860. Epub 2017 Jun 29.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China.

This retrospective study aimed to investigate the clinical value of local surgery in stage IV BC and determined whether the survival outcomes were affected by the breast cancer subtype (BCS). Women with de novo stage IV BC from 2010 to 2013 were included using the Surveillance Epidemiology and End Results database. Univariate and multivariate Cox regression analyses were performed to evaluate the prognostic factors for breast cancer-specific survival (BCSS) and overall survival (OS). Among 9,256 patients were identified, 3,130 (33.8%) were received local surgery. Patients with hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)- subtype were less likely to receive local surgery, while HR-/HER2- tumors were more likely to receive surgery. Multivariate analyses revealed that local surgery improved survival, surgical intervention was an independent favorable prognostic factor for BCSS (P < 0.001) and OS (P < 0.001). Patients who receipt of surgery had better survival outcomes compared with the non-surgery group, and the survival benefits of local surgery were not affected by the BCS status. Local surgery was improved survival for patients with stage IV BC regardless of the BCS status.
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http://dx.doi.org/10.18632/oncotarget.18889DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5620218PMC
September 2017

Preoperative radiotherapy improves survival in rectal signet-ring cell carcinoma-a population-based study.

Radiat Oncol 2017 Aug 23;12(1):141. Epub 2017 Aug 23.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, People's Republic of China.

Background: To investigate the clinical value of preoperative and postoperative radiotherapy (RT) in patients with rectal signet-ring cell carcinoma (SRCC).

Methods: Using the Surveillance, Epidemiology, and End Results program patients with stage II-III rectal SRCC were retrospectively included between 1988 and 2012. Univariate and multivariate Cox regression analyses were performed to analyze the effect of preoperative and postoperative RT on cause-specific survival (CSS).

Results: A total of 292 patients were included: 138 patients received preoperative RT, 101 patients received postoperative RT, and 53 patients underwent surgery alone. Overall, 5- and 10-year CSS was 43.8 and 37.6%, respectively. Preliminary survival analysis demonstrated that preoperative RT improved CSS versus surgery alone, especially in patients with stage III disease. Multivariate analysis demonstrated that preoperative RT was independent predictors for CSS in stage III rectal SRCC. CSS in preoperative and postoperative RT groups was comparable.

Conclusions: Preoperative RT significantly improved survival outcomes in patients with stage III rectal SRCC.
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http://dx.doi.org/10.1186/s13014-017-0874-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568054PMC
August 2017

The effect of distant metastases sites on survival in de novo stage-IV breast cancer: A SEER database analysis.

Tumour Biol 2017 Jun;39(6):1010428317705082

4 Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China.

To investigate the effect of distant metastases sites on survival in patients with de novo stage-IV breast cancer. From 2010 to 2013, patients with a diagnosis of de novo stage-IV breast cancer were identified using the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression analyses were performed to analyze the effect of distant metastases sites on breast cancer-specific survival and overall survival. A total of 7575 patients were identified. The most common metastatic sites were bone, followed by lung, liver, and brain. Patients with hormone receptor+/human epidermal growth factor receptor 2- and hormone receptor+/human epidermal growth factor receptor 2+ status were more prone to bone metastases. Lung and brain metastases were common in hormone receptor-/human epidermal growth factor receptor 2+ and hormone receptor-/human epidermal growth factor receptor 2- subtypes, and patients with hormone receptor+/ human epidermal growth factor receptor 2+ and hormone receptor-/human epidermal growth factor receptor 2+ subtypes were more prone to liver metastases. Patients with liver and brain metastases had unfavorable prognosis for breast cancer-specific survival and overall survival, whereas bone and lung metastases had no effect on patient survival in multivariate analyses. The hormone receptor-/human epidermal growth factor receptor 2- subtype conferred a significantly poorer outcome in terms of breast cancer-specific survival and overall survival. hormone receptor+/human epidermal growth factor receptor 2+ disease was associated with the best prognosis in terms of breast cancer-specific survival and overall survival. Patients with liver and brain metastases were more likely to experience poor prognosis for breast cancer-specific survival and overall survival by various breast cancer subtypes. Distant metastases sites have differential impact on clinical outcomes in stage-IV breast cancer. Follow-up screening for brain and liver metastases might be effective in improving breast cancer-specific survival and overall survival.
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http://dx.doi.org/10.1177/1010428317705082DOI Listing
June 2017

The prognostic value of histologic subtype in node-positive early-stage cervical cancer after hysterectomy and adjuvant radiotherapy.

Int J Surg 2017 Aug 2;44:1-6. Epub 2017 Jun 2.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China. Electronic address:

Background: To assess the survival outcomes in patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-IIA adenocarcinoma (AC) or squamous cell carcinoma (SCC) of the uterine cervix after hysterectomy and adjuvant radiotherapy (RT).

Methods: Patients with a primary diagnosis of FIGO stage I-IIA AC or SCC of the uterine cervix after hysterectomy and adjuvant RT between 1988 and 2012 were included using data from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression analyses were used to analyze the effect of histologic subtype on cause-specific survival (CSS) and overall survival (OS).

Results: We included 1171 patients: 919 with cervical SCC and 252 with cervical AC. In multivariate analysis, cervical AC was an independent adverse prognostic factor for survival. Patients with cervical AC had worse CSS (p = 0.001) and OS (p = 0.001) compared to patients with cervical SCC. In the subgroup analysis, patients with cervical SCC in the era of concurrent chemoradiotherapy (CCRT) (2000-2012) had better CSS (p = 0.006) and OS (p = 0.004) compared with the era of RT. However, there was no significant difference in CSS (p = 0.079) and OS (p = 0.053) between the eras of RT (1988-1999) and CCRT for patients with cervical AC.

Conclusions: Survival of cervical AC is significantly worse than that of cervical SCC. As CCRT usage increases, the survival benefit is derived only in cervical SCC, but not in cervical AC.
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http://dx.doi.org/10.1016/j.ijsu.2017.05.074DOI Listing
August 2017

Men and women show similar survival outcome in stage IV breast cancer.

Breast 2017 Aug 31;34:115-121. Epub 2017 May 31.

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China. Electronic address:

Purpose: To evaluate the clinicopathological features, patterns of distant metastases, and survival outcome between stage IV male breast cancer (MBC) and female breast cancer (FBC).

Methods: Patients diagnosed with stage IV MBC and FBC between 2010 and 2013 were included using the Surveillance, Epidemiology, and End Results program. Univariate and multivariate Cox regression analyses were used to analyze risk factors for overall survival (OS).

Results: A total of 4997 patients were identified, including 60 MBC and 4937 FBC. Compared with FBC, patients with MBC were associated with a significantly higher rate of estrogen receptor-positive, progesterone receptor-positive, unmarried, lung metastases, and a lower frequency of liver metastases. Univariate and multivariate analyses showed no significant difference in OS between MBC and FBC. In the propensity score-matched population, there was also no difference in survival between MBC and FBC. Multivariate analysis of MBC showed that OS was longer for patients aged 50-69 years and with estrogen receptor-positive disease.

Conclusions: There was no significant difference in survival outcome between stage IV MBC and FBC, but significant differences in clinicopathological features and patterns of metastases between the genders.
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http://dx.doi.org/10.1016/j.breast.2017.05.012DOI Listing
August 2017

Clinicopathological features of small cell carcinoma of the uterine cervix in the surveillance, epidemiology, and end results database.

Oncotarget 2017 Jun;8(25):40425-40433

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China.

To investigate the clinicopathological characteristics and survival of small cell carcinoma of the cervix using Surveillance, Epidemiology, and End Results database. Patients with a diagnosis of small cell carcinoma of the cervix were included between 1988 and 2012. Kaplan-Meier method and Cox regression models were used. A total of 487 patients were included. Of the patients with known International Federation of Gynecology and Obstetrics stage and tumor grade, the stage IV disease was diagnosed in 37.9% patients, and 98.5% patients had poorly or undifferentiated histology. The 5-year cause specific survival and overall survival were 33.0% and 29.4%, respectively. In multivariate analysis, increasing age, advanced stage, and treatment by primary radiotherapy were associated with worse survival outcomes. Small cell carcinoma of the cervix is a rare disease with aggressive characteristics and prone to metastasize and is dismal in prognosis. Reduced survival was associated with increasing age, advanced stage, and treatment by primary radiotherapy.
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http://dx.doi.org/10.18632/oncotarget.16390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522189PMC
June 2017