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Pattern and risk factors for postoperative recurrence in borderline resectable pancreatic cancer after upfront surgery 认领 引用
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作者 Han-Xuan Wang Qing Zhao +3 位作者 Jin-Can Huang Qiang He Shao-Cheng Lyu Ren Lang 《World Journal of Gastroenterology》 SCIE CAS 2026年第23期78-96,共19页
BACKGROUND Postoperative recurrence is the main cause of treatment failure in borderline resectable pancreatic cancer(BRPC)patients.Elaborating patterns and risk factors for tumor recurrence can help clinicians tailor... BACKGROUND Postoperative recurrence is the main cause of treatment failure in borderline resectable pancreatic cancer(BRPC)patients.Elaborating patterns and risk factors for tumor recurrence can help clinicians tailor treatment decision,thereby improving the clinical outcome of these patients.However,although upfront surgery serves as an important treatment option for BRPC patients and can lead to distinct recurrence risks and patterns,the exact characteristics of postoperative recurrence in these patients were unclear.AIM To describe the pattern of postoperative recurrence and identify its risk factors in BRPC patients receiving upfront surgery.METHODS This retrospective study analyzed 216 BRPC patients receiving upfront surgeries.Preoperative data,surgical condition,pathology and postoperative prognosis were analyzed.Kaplan-Meier method was applied for survival comparison.Risk factors for disease-free survival(DFS)and tumor recurrence were identified with Cox and logistic regression.Fine-Gray analysis was applied to adjust for competing event.Restricted cubic splines were used to evaluate the dose-response correlation and receiver operating characteristic analysis was applied for determination of optimal cutoff value.RESULTS Of 72.7%patients experienced postoperative recurrence with a medium DFS of 11 months.Most recurrences occurred within postoperative year one,and liver was the most common recurrence site.Patients with early recurrence had decreased post-recurrence survival compared to late recurrence patients(P<0.001).Preoperative[carcinoembryonic antigen(CEA),hazard risk(HR)=1.021,95%confidence interval(CI):1.002-1.040,P=0.029],tumor diameter(HR=1.101,95%CI:1.003-1.320,P=0.044),differentiation(HR=0.662,95%CI:0.473-0.927,P=0.016)and lymph node metastasis(HR=1.491,95%CI:1.009-2.202,P=0.045)were independent risk factors for DFS.Preoperative CEA[relative risk(RR)=1.083,95%CI:1.008-1.163,P=0.029],tumor diameter(RR=1.236,95%CI:1.013-1.507,P=0.037),differentiation(RR=0.508,95%CI:0.271-0.951,P=0.034)and lymph node metastasis(RR=2.151,95%CI:1.007-4.297,P=0.030)were independent risk factors for early recurrence.Vascular invasion extent showed limited association with postoperative recurrence.CONCLUSION Most postoperative tumor recurrences occurred in postoperative year one in BRPC patients receiving upfront surgery,and liver was the most common site of recurrence.Preoperative CEA,tumor size,differentiation and lymph node metastasis were risk factors for DFS and early postoperative recurrence. 展开更多
关键词 Borderline resectable pancreatic cancer Upfront surgery Tumor recurrence Pattern Risk factor
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Development and validation of a predictive model for portal-systemic venous invasion grading in borderline resectable pancreatic cancer 认领 引用
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作者 Fang-Fei Wang Xiao-Di Dai +2 位作者 Xin Zhao Qiang He Shao-Cheng Lyu 《World Journal of Gastroenterology》 SCIE CAS 2025年第42期103-113,共11页
BACKGROUND Portosystemic venous invasion(PSVI)depth critically influences prognosis in borderline resectable pancreatic cancer(BRPC),necessitating precise preoperative discrimination for personalized therapy.AIM To de... BACKGROUND Portosystemic venous invasion(PSVI)depth critically influences prognosis in borderline resectable pancreatic cancer(BRPC),necessitating precise preoperative discrimination for personalized therapy.AIM To develop and validate a preoperative nomogram integrating computed to-mography parameters and carbohydrate antigen 19-9(CA19-9)kinetics for pre-dicting PSVI depth in treatment-naive BRPC.METHODS This retrospective cohort study analyzed 167 BRPC patients undergoing radical resection between 2011 and 2023.Patients were stratified by pathological PSVI depth[no venous invasion(VI)/adventitial/muscularis propria/intimal].Kaplan-Meier and ordinal logistic regression identified preoperative predictors from clinical/laboratory/computed tomography parameters(e.g.,circumferential involvement and CA19-9).A nomogram was developed and validated via cali-bration curves/decision curve analysis.RESULTS PSVI depth significantly stratified survival.:Intimal VI showed worst prognosis(median overall survival:9 months,5-year overall survival:0%vs no VI:17 months,12.5%;P<0.001).Independent predictors:CA19-9[odds ratio(OR)=3.819,Wald=14.125,95%confidence interval(CI):1.980-7.410],circumferential involvement(OR=8.271,Wald=33.352,95%CI:3.950-17.320),and luminal compromise(OR=3.544,Wald=8.489,95%CI:1.818-6.447).The nomogram achieved C-index=0.928(95%CI:0.889-0.967),with 100-250 points indicating high invasiveness risk.Decision curve analysis confirmed clinical utility(threshold:0-0.7).CONCLUSION This model integrates routine indicators to preoperatively quantify PSVI depth,guiding precision treatment. 展开更多
关键词 Borderline resectable pancreatic cancer Portosystemic venous invasion Pathological grading Predictive model Adventitial invasion Muscularis propria invasion Intimal invasion
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Management of Borderline Personality Disorder Crises in the Emergency Room: A Case Study 认领 引用
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作者 Taqialdeen Zamil Talato Kabore +1 位作者 Ayman Tailakh Khadija Hamisi 《Open Journal of Medical Psychology》 2025年第1期32-40,共9页
This case study describes the care provided to a female patient with borderline personality disorder (BPD) who presented to the emergency department (ED). While people with borderline personality disorder use emergenc... This case study describes the care provided to a female patient with borderline personality disorder (BPD) who presented to the emergency department (ED). While people with borderline personality disorder use emergency services frequently, clinicians often face difficulties when providing medical and behavioral services to these patients. It may be difficult for nurse practitioners to determine if a patient with BPD who presents to the ED in crisis should be admitted, medicated, observed, or discharged. Self-harm is frequently confused with suicide attempts, which can result in unnecessary hospitalizations. This case study seeks to examine the proper management and difficulties encountered by healthcare providers in managing crises involving individuals with BPD in ED settings. The case study underscores the significance of thorough evaluation, recognition of BPD characteristics, active engagement in treatment, the therapeutic alliance, and the emphasis on interpersonal connections and stressors alongside the utilization of psychopharmacology. 展开更多
关键词 Borderline Personality Disorder Psychiatric Crises Borderline Personality Crises
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Diagnostic and management challenges in a partially infarcted borderline phyllodes tumor in an adolescent female:A case report and review of literature 认领 引用
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作者 Elizabeth Suschana Flora Mae Sta Ines +3 位作者 Padmini Manrai Susan Koelliker Jennifer S Gass Yun-An Tseng 《World Journal of Clinical Pediatrics》 2025年第3期351-360,共10页
BACKGROUND Fibroadenomas(FA)and phyllodes tumors(PT)are fibroepithelial neoplasms and are difficult to differentiate radiographically and histologically.We present a partially infarcted borderline PT in an adolescent ... BACKGROUND Fibroadenomas(FA)and phyllodes tumors(PT)are fibroepithelial neoplasms and are difficult to differentiate radiographically and histologically.We present a partially infarcted borderline PT in an adolescent with rapid tumor enlargement within 24 hours.Tumor infarction made the diagnostic work-up difficult.Com-plete surgical excision is the standard of care for PTs.There is controversy regar-ding margin re-excision for borderline PTs.In this report,we discuss the diagno-stic challenges of PT and the evolving concept of margin status on PT recurrence rate.CASE SUMMARY A 14-year-old healthy female with no medical history presented with a painful right breast mass with no nipple discharge,trauma,or skin findings.The mass showed rapid enlargement over 24 hours,prompting a workup with ultrasound and core needle biopsy.The initial biopsy was limited due to large areas of in-farction.Based on the scant viable tissue and considering the patient’s age,the mass was favored to be a juvenile FA.The patient underwent excision of the mass.Final pathology confirmed a borderline PT with positive surgical margins.The patient underwent margin re-excision,which did not show any residual tumor.At the 6-month post-op visit,there was a mass-forming lesion on the breast ultrasound.Subsequent core needle biopsy showed benign breast parenchyma with scar formation.The primary goal of evaluation in pediatric breast masses is to do no harm.However,rapidly growing and symptomatic masses require a more extensive work-up including biopsy and surgical excision.We present a rapidly growing breast mass in a 14-year-old female which was diagnosed as a borderline PT on her excision specimen.The mass rapidly enlarged over 24 hours.The initial biopsy pathology was limited due to a large area of infarction.The patient underwent excision of the mass.Final pathology confirmed a borderline PT that extended into the surgical margin,resulting in an additional re-excision procedure.Accurate diagnosis prior to surgical intervention is crucial to avoid additional procedures.Although histological morphology remains the gold standard for diagnosis,immunohistochemistry and molecular studies have recently shown to improve the accuracy of diagnosis of PTs.Long-term clinical and pathologic follow-up of PTs in adolescent patients should be collectively studied to examine whether our current diagnostic criteria for PT can reliably predict tumor behavior in this age group.CONCLUSION Accurate diagnosis of PTs requires surgical excision.Tumor infarction may lead to rapid tumor enlargement,hindering the correct diagnosis.More research is needed on margin status and recurrence rate,especially in adolescent patients,to help establish the best possible care for this age group. 展开更多
关键词 Borderline phyllodes tumor Adolescent breast tumor Infarction Diagnostic challenge Local recurrence Surgical margins Case report
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Optimizing neoadjuvant chemoradiation in resectable and borderline resectable pancreatic cancer: Evidence-based insights 认领 引用
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作者 Gautam Sarma Hima Bora Partha P Medhi 《World Journal of Clinical Oncology》 2025年第7期78-92,共15页
Since its inception,localized pancreatic cancer has been identified as a systemic illness.Hence,to increase its survival rates,surgical resection followed by ad-juvant chemotherapy is used as a treatment option.A sign... Since its inception,localized pancreatic cancer has been identified as a systemic illness.Hence,to increase its survival rates,surgical resection followed by ad-juvant chemotherapy is used as a treatment option.A significant barrier,though,is the high morbidity and drawn-out recovery after extensive surgical resection,which may postpone or prohibit the prompt administration of adjuvant therapy.Thereby,acknowledging the efficacy of neoadjuvant therapy in various digestive tract malignancies like rectal,gastric,and oesophagal cancers in en-hancing long-term survival and the likelihood of successful resection,researchers have turned their attention to exploring its potential benefits in the context of both resectable and borderline resectable pancreatic cancer(RPC).According to recent data,neoadjuvant chemoradiation has major advantages for both resectable and borderline RPC.These advantages include increased surgical resection rates,longer survival times,decreased recurrence rates,and better overall disease control with a manageable toxicity profile.Despite its benefits,research is still being done to determine the best way to sequence and combine chemotherapy and radiation.Furthermore,studies have demonstrated the potential for cus-tomized therapy regimens based on the patient’s general health status and the tumor’s biological behavior to maximize the neoadjuvant approach.As progress continues,neoadjuvant chemoradiation is set to become a key component of treatment for both resectable and borderline RPC,providing a more efficient way to manage this deadly condition.While further development is required to fully grasp its potential in enhancing long-term patient outcomes,evidence supports its increasing usage in clinical practice. 展开更多
关键词 Pancreatic adenocarcinoma Resectable pancreatic cancer Borderline rese-ctable pancreatic cancer Neoadjuvant therapy Adjuvant therapy
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Borderline resectable pancreatic cancer: Definitions and management 认领 引用 被引量：14
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作者 Nicole E Lopez Cristina Prendergast Andrew M Lowy 《World Journal of Gastroenterology》 SCIE CAS 2014年第31期10740-10751,共12页
Pancreatic cancer is the fourth leading cause of cancer death in the United States. While surgical resection remains the only curative option, more than 80% of patients present with unresectable disease. Unfortunately... Pancreatic cancer is the fourth leading cause of cancer death in the United States. While surgical resection remains the only curative option, more than 80% of patients present with unresectable disease. Unfortunately, even among those who undergo resection, the reported median survival is 15-23 mo, with a 5-year survival of approximately 20%. Disappointingly, over the past several decades, despite improvements in diagnostic imaging, surgical technique and chemotherapeutic options, only modest improvements in survival have been realized. Nevertheless, it remains clear that surgical resection is a prerequisite for achieving longterm survival and cure. There is now emerging consensus that a subgroup of patients, previously considered poor candidates for resection because of the relationship of their primary tumor to surrounding vasculature, may benefit from resection, particularly when preceded by neoadjuvant therapy. This stage of disease, termed borderline resectable pancreatic cancer, has become of increasing interest and is now the focus of a multiinstitutional clinical trial. Here we outline the history, progress, current treatment recommendations, and future directions for research in borderline resectable pancreatic cancer. 展开更多
关键词 Pancreatic cancer Borderline resectable pancreatic cancer Neoadjuvant Vascular resection Pancreaticoduodenectomy Whipple
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Pancreaticoduodenectomy for borderline resectable pancreatic head cancer with a modified artery-first approach technique 认领 引用 被引量：8
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作者 Min Wang Hang Zhang +4 位作者 Feng Zhu Feng Peng Xin Wang Ming Shen Ren-Yi Qin 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2017年第2期215-221,共7页
BACKGROUND： The treatment of borderline resectable pancreatic head cancer（BRPHC） is still controversial and challenging. The artery-first approaches are described to be the important options for the early determina... BACKGROUND： The treatment of borderline resectable pancreatic head cancer（BRPHC） is still controversial and challenging. The artery-first approaches are described to be the important options for the early determination. Whether these approaches can achieve an increase R0 rate, better bleeding control and increasing long-term survival for BRPHC are still controversial. We compared a previously reported technique, a modified artery-first approach（MAFA）, with conventional techniques for the surgical treatment of BRPHC.METHODS： A total of 117 patients with BRPHC undergone pancreaticoduodenectomy（PD） from January 2013 to June 2015 were included. They were divided into an MAFA group（n=78） and a conventional-technique group（n=39）. Background characteristics, operative data and complications were compared between the two groups.RESULTS： Mean operation time was significantly shorter in the MAFA group than that in the conventional-technique group（313 vs 384 min; P=0.014）; mean volume of intraoperative blood loss was significantly lower in the MAFA group than that in the conventional-technique group（534 vs 756 m L; P=0.043）; and mean rate of venous resection was significantly higher in the conventional-technique group than that in the MAFA group（61.5% vs 35.9%; P=0.014）. Pathologic data, early mortality and morbidity were not different significantly between the two groups.CONCLUSIONS： MAFA is safe, simple, less time-consuming, less intraoperative blood loss and less venous resection, and therefore, may become a standard surgical approach to PD for BRPHC with the superior mesenteric vein-portal vein involvement but without superior mesenteric artery invasion. 展开更多
关键词 pancreatic head cancer pancreaticoduodenectomy borderline resectable
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Isolated subcutaneous implantation of a borderline ovarian tumor:A case report and review of the literature 认领 引用 被引量：4
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作者 Malgorzata Banys-Paluchowski Borsu Yeganeh +6 位作者 Jutta Luettges Achim Maibach Ruediger Langenberg Natalia Krawczyk Peter Paluchowski Holger Maul Gerhard Gebauer 《World Journal of Clinical Oncology》 2016年第2期270-274,共5页
Laparoscopy-related tumor implantations of gynecological malignancies into the subcutaneous tissue are rarely diagnosed.We report an interesting case of a 46-year-old female who presented with an abdominal subcutaneou... Laparoscopy-related tumor implantations of gynecological malignancies into the subcutaneous tissue are rarely diagnosed.We report an interesting case of a 46-year-old female who presented with an abdominal subcutaneous metastasis of a borderline ovarian tumor.The patient received a laparoscopic unilateral adnexectomy for a solid-cystic tumor of the right ovary.Histopathological workup showed a papillary borderline tumor of mucinous type.Nine days later she underwent a hysterectomy,left adnexectomy,appendectomy and omentectomy.Exploration of the peritoneum revealed no intraperitoneal implants.Further exploration showed a non-invasive implant of a borderline tumor in the subcutaneous tissue above the fascia that had no contact to the peritoneum.It is hypothesized that tumor cells may have been implanted during a previous laparoscopy,the most recent of which had been fourteen years prior to her current presentation.Various risk factors for port-site malignancies have been identified.Tumor manipulation and extraction of tumor tissue without a protective bag may contribute to development of trocarsite metastasis. 展开更多
关键词 Laparoscopy Subcutaneous metastasis Tumor implantation Borderline tumor of the ovary
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Borderline resectable pancreatic cancer:Certainties and controversies 认领 引用 被引量：2
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作者 Gennaro Nappo Greta Donisi Alessandro Zerbi 《World Journal of Gastrointestinal Surgery》 SCIE 2021年第6期516-528,共13页
Borderline resectable(BR)pancreatic ductal adenocarcinoma(PDAC)is currently a well-recognized entity,characterized by some specific anatomic,biological and conditional features:It includes patients with a stage of dis... Borderline resectable(BR)pancreatic ductal adenocarcinoma(PDAC)is currently a well-recognized entity,characterized by some specific anatomic,biological and conditional features:It includes patients with a stage of disease intermediate between the resectable and the locally advanced ones.The term BR identifies a tumour with an aggressive biological behaviour,on which a neoadjuvant approach instead of an upfront surgery one should be preferred,in order to obtain a radical resection(R0)and to avoid an early recurrence after surgery.Even if during the last decades several studies on this topic have been published,some aspects of BR-PDAC still represent a matter of debate.The aim of this review is to critically analyse the available literature on this topic,particularly focusing on:The problem of the heterogeneity of definition of BR-PDAC adopted,leading to a misinterpretation of published data;its current management(neoadjuvant vs upfront surgery);which neoadjuvant regimen should be preferably adopted;the problem of radiological restaging and the determination of resectability after neoadjuvant therapy;the post-operative outcomes after surgery;and the role and efficacy of adjuvant treatment for resected patients that already underwent neoadjuvant therapy. 展开更多
关键词 Borderline resectable pancreatic cancer Pancreatic cancer Neoadjuvant treatment Chemotherapy Radiotherapy Pancreatic tumour
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Is There Re-staging Surgery Necessity for Borderline Ovarian Tumors 认领 引用
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作者 Li-li GUO Xiao-yan KANG +5 位作者 Yue SU Xiao-yu LIU Xue WU Wan XIE Yu-huan LIU Chang-yu WANG 《Current Medical Science》 SCIE CAS 2023年第4期822-830,共9页
Objective:This study assessed the necessity of surgical re-staging in women with borderline ovarian tumors(BOTs)and evaluated the impact of complete surgical staging,lymphadenectomy,and omentectomy on disease recurren... Objective:This study assessed the necessity of surgical re-staging in women with borderline ovarian tumors(BOTs)and evaluated the impact of complete surgical staging,lymphadenectomy,and omentectomy on disease recurrence and survival.Methods:We retrospectively reviewed the medical records of patients with BOTs.A total of 901 patients were eligible for inclusion in the study,and we evaluated some of the variables and clinical/surgical characteristics of the cases.The effects of the type of surgical procedure,surgical staging,and complete or incomplete staging on recurrence were calculated.The rates of disease-free survival,overall survival,and recurrence were compared according to complete surgical staging.A Cox regression analysis was performed to identify potential prognostic factors,and survival curves were constructed using the Kaplan-Meier method.Results:The overall recurrence rate was 13.9%,and recurrence was comparable between the complete surgical staging group and the incomplete groups(P>0.05).The performance of complete surgical staging did not show an effect on long-term survival,and complete surgical staging,omentectomy,and lymphadenectomy had no effect on recurrence.In multivariate analyses,only radical surgery and adjuvant chemotherapy were risk factors for the recurrence of BOTs.Furthermore,we found that omentectomy led to a relatively low recurrence rate in patients with International Federation of Gynecology and Obstetrics(FIGO)stage>Ⅰ(P=0.022).Conclusion:Our results suggest that complete surgical staging should be considered a standard treatment for patients with advanced stage BOTs but not for those at FIGO stageⅠ.It might be safe to reduce the scope of surgical procedures in patients with early-stage BOTs.However,it is not necessary to perform re-staging operations for BOTs with a macroscopically normal extra-ovarian appearance. 展开更多
关键词 borderline ovarian tumor staging surgery management recurrence
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Borderline resectable for colorectal liver metastases:Present status and future perspective 认领 引用
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作者 Yuki Kitano Hiromitsu Hayashi +8 位作者 Takashi Matsumoto Shotaro Kinoshita Hiroki Sato Yuta Shiraishi Yosuke Nakao Takayoshi Kaida Katsunori Imai Yo-ichi Yamashita Hideo Baba 《World Journal of Gastrointestinal Surgery》 SCIE 2021年第8期756-763,共8页
Surgical resection for colorectal liver metastases(CRLM)may offer the best opportunity to improve prognosis.However,only about 20% of CRLM cases are indicated for resection at the time of diagnosis(initially resectabl... Surgical resection for colorectal liver metastases(CRLM)may offer the best opportunity to improve prognosis.However,only about 20% of CRLM cases are indicated for resection at the time of diagnosis(initially resectable),and the remaining cases are treated as unresectable(initially unresectable).Thanks to recent remarkable developments in chemotherapy,interventional radiology,and surgical techniques,the resectability of CRLM is expanding.However,some metastases are technically resectable but oncologically questionable for upfront surgery.In pancreatic cancer,such cases are categorized as"borderline resectable",and their definition and treatment strategies are explicit.However,in CRLM,although various poor prognosis factors have been identified in previous reports,no clear definition or treatment strategy for borderline resectable has yet been established.Since the efficacy of hepatectomy for CRLM was reported in the 1970 s,multidisciplinary treatment for unresectable cases has improved resectability and prognosis,and clarifying the definition and treatment strategy of borderline resectable CRLM should yield further improvement in prognosis.This review outlines the present status and the future perspective for borderline resectable CRLM,based on previous studies. 展开更多
关键词 Borderline resectable Colorectal liver metastases Adjuvant chemotherapy Hepatectomy Colorectal cancer
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Cognitive impairment in patients with bipolar disorder alone versus those with bipolar disorder comorbid with borderline personality disorder 认领 引用
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作者 Chao-Min Wang Hua Xue +5 位作者 Bo Xin Kun Zhang Shuo Wang Jin-Cheng Wang Cui-Xia An Na Li 《World Journal of Psychiatry》 SCIE 2024年第8期1174-1181,共8页
BACKGROUND Bipolar disorder(BD)is a severe mental illness.BD often coexists with borderline personality disorders,making the condition more complex.AIM To explore the differences in cognitive impairment between patien... BACKGROUND Bipolar disorder(BD)is a severe mental illness.BD often coexists with borderline personality disorders,making the condition more complex.AIM To explore the differences in cognitive impairment between patients with BD and those with BD comorbid with borderline personality disorder.METHODS Eighty patients with BD and comorbid borderline personality disorder and 80 patients with BD alone were included in groups A and B,respectively,and 80 healthy volunteers were included as controls.Cognitive function in each group was evaluated using the Chinese version of the repeatable battery for the assess-ment of neuropsychological status(RBANS),the Stroop color-word test,and the Wechsler intelligence scale-revised(WAIS-RC).RESULTS The indices of the RBANS,Stroop color-word test,and WAIS-RC in groups A and B were significantly lower than those of the control group(P<0.05).Group A had significantly longer Stroop color-word test times for single-character,single-color,double-character,and double-color,lower scores of immediate memory,visual breadth,verbal function dimensions and total score of the RBANS,as well as lower scores of verbal IQ,performance IQ,and overall IQ of the WAIS-RC compared with group B(P<0.05).Compared to group B,group A exhibited significantly longer single-character time,single-color time,double-character time,and double-color time in the Stroop color-word test(P<0.05).CONCLUSION The cognitive function of patients with BD complicated with borderline personality disorder is lower than that of patients with BD. 展开更多
关键词 Bipolar disorder Borderline personality disorder Cognitive impairment Chinese-version repeatable neuropsychological status test Stroop color-word test Wechsler intelligence scale
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Pathologic tumor response to neoadjuvant therapy in borderline resectable pancreatic cancer 认领 引用 被引量：3
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作者 June S Peng Jane Wey +3 位作者 Sricharan Chalikonda Daniela S Allende R Matthew Walsh Gareth Morris-Stiff 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2019年第4期373-378,共6页
Background:Previous studies have demonstrated the prognostic significance of pathologic tumor response in pancreatic adenocarcinoma following neoadjuvant therapy(NAT).The aim of this study was to determine the inciden... Background:Previous studies have demonstrated the prognostic significance of pathologic tumor response in pancreatic adenocarcinoma following neoadjuvant therapy(NAT).The aim of this study was to determine the incidence of significant pathologic response to NAT in borderline resectable pancreatic cancer(BRPC),and association of NAT regimen and other clinico-pathologic characteristics with pathologic response.Methods:Patients with BRPC who underwent NAT and pancreatic resection between January 2012 and June 2017 were included.Pathologic response was assessed on a qualitative scale based on the College of American Pathologists grading system.Demographics and baseline characteristics,oncologic treatment,pathology,and survival outcomes were compared.Results:Seventy-one patients were included for analysis.Four patients had complete pathologic responses(tumor regression score 0),12 patients had marked responses(score 1),42 had moderate responses(score 2),and 13 had minimal responses(score 3).Patients with complete or marked responses were more likely to have received neoadjuvant gemcitabine chemoradiation(62.5%,38.1%,and 23.1%of the complete/marked,moderate,and minimal response groups,respectively;P=0.04).Of the complete/marked,moderate,and minimal response groups,margins were negative in 75.0%,78.6%,and 46.2%(P=0.16);node negative disease was observed in 87.5%,54.8%,and 15.4%(P<0.01);and median overall survival was 50.0 months,31.7 months,and 23.2 months(P=0.563).Of the four patients with pathologic complete responses,three were disease-free at 66.1,41.7 and 31.4 months,and one was deceased with metastatic liver disease at 16.9 months.Conclusions:A more pronounced pathologic tumor response to NAT in BRPC is correlated with node negative disease,but was not associated with a statistically significant survival benefit in this study. 展开更多
关键词 Pancreatic cancer Borderline resectable Neoadjuvant therapy Pathologic response
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Comprehensive multimodal management of borderline resectable pancreatic cancer:Current status and progress 认领 引用 被引量：3
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作者 Hong-Yu Wu Jin-Wei Li +4 位作者 Jin-Zheng Li Qi-Long Zhai Jing-Yuan Ye Si-Yuan Zheng Kun Fang 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第2期142-162,共21页
Borderline resectable pancreatic cancer(BRPC)is a complex clinical entity with specific biological features.Criteria for resectability need to be assessed in combination with tumor anatomy and oncology.Neoadjuvant the... Borderline resectable pancreatic cancer(BRPC)is a complex clinical entity with specific biological features.Criteria for resectability need to be assessed in combination with tumor anatomy and oncology.Neoadjuvant therapy(NAT)for BRPC patients is associated with additional survival benefits.Research is currently focused on exploring the optimal NAT regimen and more reliable ways of assessing response to NAT.More attention to management standards during NAT,including biliary drainage and nutritional support,is needed.Surgery remains the cornerstone of BRPC treatment and multidisciplinary teams can help to evaluate whether patients are suitable for surgery and provide individualized management during the perioperative period,including NAT responsiveness and the selection of surgical timing. 展开更多
关键词 Borderline resectable pancreatic cancer Neoadjuvant therapy Resectability Surgery Multimodality treatment Multidisciplinary teams
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Affect regulation in psychoanalytic treatments of patients with a borderline personality disorder–psychoanalysis and psychodynamic psychotherapy–a comparison 认领 引用 被引量：1
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作者 Dagmar Steinmair Guoruey Wong +2 位作者 Sophie Frantal Christine Rohm Henriette Löffler-Stastka 《World Journal of Psychiatry》 SCIE 2021年第12期1328-1345,共18页
BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently understood.Evidence of differences between different typ... BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently understood.Evidence of differences between different types of therapies has been questioned.AIM To study repetitive interaction patterns in patients with BPD undergoing either psychoanalysis or psychodynamic therapy.METHODS Psychoanalysis(PSA)or psychodynamic psychotherapy(PDT)was administered to 10 patients each,the two groups were matched.Therapy regimens were applied according to care as usual/manualized including quality control and supervision as usual.Randomization to one of the groups was done after baseline assessment.During classical PSA(n=10)and PDT(n=10),semiannually,recordings(audio or video)of five consecutive therapy sessions were taken over three years for an ex-post analysis.The patients'characteristics,such as affect parameters[Affect regulation and experience Q-sort(AREQ)],quality of object relations(quality of object relations scale)and personality traits[Shedler-Westen Assessment Procedure(SWAP-200)]were analyzed retrospectively by independent raters.Therapeutic action(psychotherapy process Q-sort)and affective(re)actions of the patients(AREQ)were then analyzed in relation to changes found in the patients'characteristics.RESULTS During the first year of therapy(PSA:n=10;PDT:n=9),the therapeutic method PSA was associated with significant improvements in the variable"SWAP Borderline",while in PDT change was not significantly different to baseline(PSA:P=0.04;PDT:P=0.33).Long-term results and follow up was available for seven participants in PSA and for five in PDT after three years;change in SWAP borderline for the whole sample was not significant at this time point when confronting to baseline(P=0.545).However,differences between PSA and PDT were significant when analyzing the“mean change”in the SWAP Borderline variable after one year of therapy(P=0.024):PSA led to slightly increased BPD symptoms,while PDT to a decrease;for the long run,variance of observed change was higher in PSA than in PDT(SDPSA±9.29 vs SDPDT±7.94).Our assumption that transference interpretations,closely followed by affective changes in the patient,could be useful modes of interaction was reproducible in our findings,especially when looking at the descriptive findings in the long-term data.The analysis of repetitive interaction structures demonstrated a very specific"time-lag"between therapeutic intervention and a corresponding increase in positive affect in successful therapy cases.CONCLUSION Exploring the change processes in the patients'characteristics and linking these changes to specific treatment strategies is of clinical importance when starting treatment and for its long-term progress. 展开更多
关键词 Psychoanalysis Psychodynamic psychotherapy Borderline personality disorder Affect regulation Affect regulation and experience Q-sort Transference
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Borderline resectable pancreatic cancer and vascular resections in the era of neoadjuvant therapy 认领 引用 被引量：2
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作者 Danko Mikulic Anna Mrzljak 《World Journal of Clinical Cases》 SCIE 2021年第20期5398-5407,共10页
While pancreatic cancer is still characterized by early systemic spread and poor outcomes,the treatment of this disease has changed significantly in recent years due to major advancements in systemic therapy and advan... While pancreatic cancer is still characterized by early systemic spread and poor outcomes,the treatment of this disease has changed significantly in recent years due to major advancements in systemic therapy and advanced surgical techniques.Broader use of effective neoadjuvant approaches combined with aggressive surgical operations within a multidisciplinary setting has improved outcomes.Borderline resectable pancreatic cancer is characterized by tumor vascular invasion,and is a setting where the combination of potent neoadjuvant chemotherapy and aggressive surgical methods,including vascular resections and reconstructions,shows its full potential.Hopefully,this will lead to improved local control and curative treatment in a number of patients with this aggressive malignancy. 展开更多
关键词 Pancreatic adenocarcinoma Borderline resectable Neoadjuvant therapy Venous resection Arterial resection Vascular reconstruction
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Neoadjuvant chemoradiation is associated with decreased lymph node ratio in borderline resectable pancreatic cancer:A propensity score matched analysis 认领 引用
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作者 June S Peng Gareth Morris-Stiff +4 位作者 Noaman S Ali Jane Wey Sricharan Chalikonda Kevin M El-Hayek R Matthew Walsh 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2021年第1期74-79,共6页
Background:Lymph node ratio(LNR)and margin status have prognostic significance in pancreatic cancer.Herein we examined the pathologic and clinical outcomes in patients with borderline resectable pancreatic cancer(BRPC... Background:Lymph node ratio(LNR)and margin status have prognostic significance in pancreatic cancer.Herein we examined the pathologic and clinical outcomes in patients with borderline resectable pancreatic cancer(BRPC)following neoadjuvant therapy(NAT)and pancreaticoduodenectomy.Methods:Patients who underwent treatment between January 1,2012 and June 30,2017 were included.Sequential patients in the BRPC group were compared to a propensity score matched cohort of patients with radiographically resectable pancreatic cancer who underwent upfront surgical resection.The BRPC group was also compared to sequential patients with radiographically resectable pancreatic cancer who required vein resection(VR)during upfront surgery.Results:There were 50 patients in the BRPC group,50 patients in the matched control group,and 38 patients in the VR group.Negative margins(R0)were seen in 72%,64%,and 34%of the BRPC,control,and VR groups,respectively(P=0.521 for BRPC vs.control;P=0.002 for BRPC vs.VR),with 24%of the BRPC group requiring a vascular resection.Nodal stage was N0 in 64%,20%,and 18%of the BRPC,control,and VR groups,respectively(P<0.001 for BRPC vs.control or VR).When nodal status was stratified into four groups(N0,or LNR≤0.2,0.2–0.4,≥0.4),the BRPC group had a more favorable distribution(P<0.001).The median overall survival were 28.8,38.6,and 19.0 months for the BRPC,control,and VR groups,respectively(log-rank P=0.096).Conclusions:NAT in BRPC was associated with more R0 and N0 resections and lower LNR compared to patients undergoing upfront resection for resectable disease. 展开更多
关键词 Neoadjuvant therapy Lymph node ratio Pancreatic cancer Borderline resectable Vein resection
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Huge mucinous borderline ovarian cystadenoma in a premenarchal girl 认领 引用
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作者 Atsushi Horiuchi Kazuhiro Kameoka +2 位作者 Kouichi Sato Yuji Yamamoto Yuji Watanabe 《Open Journal of Pediatrics》 2012年第1期82-86,共5页
Epithelial ovarian tumors are common in adult women, but rare in children. Especially mucinous ovarian cystadenoma is extremely rare, with only 16 cases in premenarchal girls reported to date. We present a case of 12-... Epithelial ovarian tumors are common in adult women, but rare in children. Especially mucinous ovarian cystadenoma is extremely rare, with only 16 cases in premenarchal girls reported to date. We present a case of 12-year-old premenarchal girl with symptoms of lower abdominal distension. CT showed a large multilocular tumor spreading throughout the entire abdominal cavity from the right upper quadrant to the pelvic cavity. The tumor was brought out little by little with aspiration of the fluid contents with a small incision. The tumor was found to originate from the left ovary, and oophorectomy was performed. The tumor measured 26 × 18 cm and weighed 5860 g. Histological diagnosis was mucinous ovarian cystadenoma with borderline malignancy. No evidence of recurrence had been seen as of 2 years postoperatively. In the review of premenarchal mucinous borderline ovarian cystadenoma, all cases were stage I and underwent salpingo-oophorectomy or oophorectomy. Those patients were alive without recurrence. Al-though mucinous borderline ovarian cystadenoma was characterized as malignancy, premenarchal cases showed favorable outcomes and salpingo-oohprectomy or oophorectomy appears appropriate. 展开更多
关键词 Ovary Mucinous Cystadenoma Borderline Tumor Premenarchal
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Borderline Weighted Estimates for Commutators of Fractional Integrals 认领 引用
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作者 Zhidan Wang Huoxiong Wu Qingying Xue 《Analysis in Theory and Applications》 CSCD 2021年第3期404-425,共22页
Let Iα,→bbe the multilinear commutators of the fractional integrals Iαwith the symbol→b=(b1,……,bk)We show that the constant of borderline weighted estimates for Iαis I/ξ,and for Iα,→bis with each bi... Let Iα,→bbe the multilinear commutators of the fractional integrals Iαwith the symbol→b=(b1,……,bk)We show that the constant of borderline weighted estimates for Iαis I/ξ,and for Iα,→bis with each bibelongs to the Orlicz space Osc_(exp Lsi). 展开更多
关键词 Commutators fractional integrals borderline weighted estimates Fefferman-Stein inequality.
Distribution of Tick Species Infesting Domestic Ruminants in Borderline of Iran-Afghanistan 认领 引用
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作者 Ahmad Jafarbekloo Hassan Vatandoost +5 位作者 Alireza Davari Faezeh Faghihi Hasan Bakhshi Maryam Roya Ramzgouyan Mohammad Nasrabadi Zakkyeh Telmadarraiy 《Journal of Biomedical Science and Engineering》 2014年第12期982-987,共6页
To determine the tick species parasitizing domestic ruminants in Zabol, Zahak and Qaen Counties which are located in east of Iran and are bordered with Afghanistan country, about 73 sheep, 44 goats and 27 cattle of 12... To determine the tick species parasitizing domestic ruminants in Zabol, Zahak and Qaen Counties which are located in east of Iran and are bordered with Afghanistan country, about 73 sheep, 44 goats and 27 cattle of 12 herds in several villages in Zabol, Zahak and Qaen Counties were inspected for tick infestation. Separated ticks were preserved in 70% alcohol and identified. About 464 ticks (252 male;194 female) were collected;the occurrences of ticks on goats, cattle and sheep were about 17%, 15% and 26% respectively in all three Counties. The mean number of ticks on each animal was about 2 - 7 ticks per animal. Totally we found 3 genera hard ticks including Hyalomma, Rhipicephalus and Dermacentor in these regions. Hyalomma anatolicum, Hy. marginatum, Hy. asiaticum, Hy. detrinium, Rhipicephalus bursa, R. sanguineus, Dermacentorniveus, and D. marginatus, were the tick species we found. Hyalomma anatolicum and Hy. asiaticum were the most abundant species in the study area. The result of this study is a survey of tick species from domestic animals in east part of Iran and implication of possible prevention measures for diseases transmitted by ticks. 展开更多
关键词 Tick Ruminants Borderline Iran Afghanistan
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