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20 April 2007, Volume 27 Issue 04 Previous Issue    Next Issue
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Leiomyosarcoma of inferior vena cava:diagnosis and treatment ZHENG Wei,LI Rong,WANG Zhong-chen,et al. 2007, 27(04): 1-273.  Abstract ( )   PDF (2316KB) ( )   Objective:To evaluate the clinical characteristics of leiomyosarcoma of inferior vena cava and to summarize the experience on the treatment of leiomyosarcoma of the inferior vena cava. Methods:The clinical data of 14 patients with leiomyosarcoma of inferior vena cava admitted between 1986 and 2006 in the General Hospital of PLA was analyzed retrospectively. Results:The diagnosis of the 12 patients was certained by pathology.Eleven cases were resected successfully with necessary reconstruction of inferior vena cava and only one patient was performed laparotomy.Two patients were not operated because of distant metastases. Conclusion:The en bloc resection with necessary reconstruction of inferior vena cava is an effective method to treat leiomyosarcoma of inferior vena cava.

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Perirenal liposarcoma:diagnosis and treatment KONG Qinglong,LI Rong,ZHENG Wei,et al. 2007, 27(04): 1-273.  Abstract ( )   PDF (307KB) ( )   Objective:To explore the appropriate surgical strategy for the treatment of perirenal liposarcoma. Methods:The clinical data of 28 cases of perirenal liposarcoma performed operation between 2000 and 2006 were analyzed retrospectively. Results:The main clinical features were abdominal mass and compression symptoms.Seventeen tumors originated from the right side and eleven from the left.Tumors were resected in all cases. Among them,19 cases were performed affected kidney resection.Ten cases were performed partial colon resection.Eight cases were performed partial small intestine resection.Two cases were performed partial stomach resection.Two cases were performed lienectomy.Five cases were performed partial diaphragma resection and thoracic close drainage.The average blood transfusion volume was 1 870 mL. Conclusion:Surgical resection is the only effective method for the treatment of perirenal liposarcoma.Preserved kidney is found to be highly related to local recurrence.Therefore,enbloc resection of the tumor with the kidney and adeps renis should be performed in the radical operation.

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Surgical treatment for abdominal tumors involving major vessels JIANG Wei-liang,SUN Qing-feng,ZHANG Ying-nan，et al. 2007, 27(04): 1-291.  Abstract ( )   PDF (389KB) ( )   Objective:To explore the clinical application of abdominal tumor resection combined with major angiectomy. Methods:The clinical data of 9 patients performed abdominal tumor resection combined with major angiectomy between September 1998 and June 2004 were analyzed retrospectively. Results:Nine patients with abdominal tumors involving major vessels were performed curative resection,which was confirmed by postoperative pathohistological examination.Resection of middleparty IVC was performed in 3 patients,resection of IVC distal to hepatic vein in 3 patients,partial IVC resection 1 patient,tumor denudation from the wall of renal vein and IVC in 1 patient,and combined IVC and AAA resection in 1 patient.Circulation reconstruction was applied after angiectomy in all the cases.No perioperative death or major complications occurred in the group.Followup study revealed longterm survival in 8 patients.One patient died of pulmonary metastasis in the 18 months after operation. Conclusion:Combined abdominal tumor resection and infiltrated major vessels can improve longterm survival significantly.

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Dermatofibrosarcoma protuberans:diagnosis and treatment CHAI Chen,FANG Guo-en,NIE Ming-ming,et al. 2007, 27(04): 1-273.  Abstract ( )   PDF (286KB) ( )   Objective:To discuss the diagnosis and treatment of Dermatofibrosarcoma protuberans (DFSP). Methods:Eleven patients with DFSP including 4 cases of DFSPFS were treated at the Changhai hospital.All patients were diagnosed by pathology.The tumor of 9 patients located at trunk and 2 at the limbs.The mean course of disease was 55 years (from one month to 40 years).Two patients underwent regional resection and other 9 patients underwent expanded resection.Three patients underwent radiotherapy after operation and the average dosage was 55Gy (50-65Gy). Results:Eleven specimens were resected.The expression of CD34 of 10 specimens was positive and 1 negative.Ten patients were followed up for 1-10 years (average 4.3 years).Tumor recurred in 6 cases.The mean recurrence time was 2.6 years (from 10 months to 5 years).There were neither distant metastasis nor death in 11 cases. Conclusion:DFSP is easy to be confused with other soft tissue tumor and its diagnosis is based on pathology chiefly. The most important management for DFSP is expanded resection.Radiotherapy should be performed if margin was positive or near the mass.Sometimes the radiotherapy can be performed alone when the tumor can not be resected.

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Prognosis of gastrointestinal stromal tumors:a study of 103 cases DU Chunyan,SHI Yingqiang,FU Hong,et al. 2007, 27(04): 1-291.  Abstract ( )   PDF (2405KB) ( )   Objective:To investigate the prognostic factors of gastrointestinal stromal tumors. Methods:The clinicopathological data of 103 patients with gastrointestinal stromal tumors admitted between January 1998 and May 2004 in Affiliated Cancer Hospital of Fudan University were analyzed restrospectively.Life table,kaplanmeier survival rate and cox regression model were used to evaluate the prognostic factors. Results:The 1 year,3 years and 5 years total survival rate of 103 patients were 86.3%，51.7%，42.8% respectively.Tumor size,Mitotic rate,primary organ of tumor and radical surgical excision or not were analyzed respectively.The differences were significiant(P<0.5).No significiant differences in sex,age,immunohistochemistry expression and multiorgan resection or not were existed between the groups. Conclusion:Flechers’ classification is ratinal,scientific,simple and feasible.Radical surgical excision is the best therapy to the primary gastrointestinal stomal tumor.

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Prognosis of the chest wall bone and soft tissue sarcomas:an analysis of 46 cases ZHANG Ya-wei,XIANG Jia-qing,SHI Ying-qiang. 2007, 27(04): 1-273.  Abstract ( )   PDF (400KB) ( )   Objective:To discuss the clinical behavior and treatment of the patients with chest wall bone and soft tissue sarcomas, and to evaluate prognostic factors for the patients. Methods:The clinical data of 46 patients with chest wall and soft tissue sarcomas performed surgical operation between January 2000 and June 2004 in Cancer Hospital of Fudan University were analyzed.Among all the patients,28 patients were treated for the first time,and other 18 patients were treated in other hospital previously and recurred.Eighteen patients were performed thoracectomy,and 9 patients were performed chest wall reconstruction.All the patients were followed up.The average followup period was 26.5 months. Life table method was used for the survival analysis. Results:The 3years diseasefree survival rate was 4843%.The surgical operation time,malignant grade,marginal states and postoperative radiotherapy were prognostic factors for univariate analyses.The primary surgically treated patients had a better prognosis than the recurred patients,and 3years diseasefree survival rates were 73% and 15%,P=00032.The patients with low histologic grade had a better prognosis than with high grade,and 3years diseasefree survival rates were 74% and 28%,P=0.0008.The patients with negative margin had a better prognosis than with positive margin,and 3years diseasefree survival rates were 64% and 13%,P=0.0005.The patients without postoperative radiotherapy had a better prognosis than with postoperative radiotherapy,and 3years diseasefree survival rates were 60% and 33%,P=0.0363.The surgical time,malignant grade,marginal states were independent predicators for the risk of recurrence at multivariate analyses. Conclusion:The diseasefree survival of the chest wall bone and soft tissue sarcomas is related to surgical treatment and tumor malignant grade.The chest wall bone and soft tissue sarcomas could be controlled by proper surgical resection.

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Hemihepatectomy by retrohepatic tunnel of the IVC of liver hanging maneuver:a report of 19cases HE Jianping,YANG Fu,XU Jing. 2007, 27(04): 1-291.  Abstract ( )   PDF (274KB) ( )   Objective:To enhance the operation safety of hemihepatectomy with improvements by retrohepatic tunnel of the IVC of liver hanging maneuver. Methods:The clinical data of 19 cases of Hemihepatectomy by retrohepatic tunnel of the IVC of liver hanging maneuver performed between November 2003 and June 2006 in the First Affiliated Hospital of Kunming Medical College were analyzed retrospectively. Results:Liver hanging tapes were placed successfully in 19 cases without related complications.Under the guidance of liver hanging tape,the IVC was protected well,and vessels of parenchyma in middle plane presented more clear. Conclusion:With retrohepatic tunnel of the IVC of liver hanging maneuver,it can not only decrease hemorrhage but also shortten the operation time.The safety can be enhanced. The transection can be performed in a thinnest and smallest resection plane.

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Prophylaxis and treatment of acute renal failure(ARF) following orthotopic liver transplantation for fulminant hepatitis LU Zheng,PENG Cheng-hong,ZHOU Guang-wen,et al. 2007, 27(04): 1-273.  Abstract ( )   PDF (431KB) ( )   Objective:To summarize the experience of prophylaxis and treatment of acute renal failure following orthotopic 1iver transplantation（OLT） for fulminant hepatitis. Methods:The clinical data of 37 patients with fulminant hepatitis undergoing OLT in Ruijin Hospital of Medical College of Shanghai Jiaotong University from September 2002 to October 2004 were analyzed retrospectively. Results:The survival rate of the graft who achieved longterm survival of 1 year was 83.8%,6 cases died in perioperative time，and the mortality was 16.2%.Postoperation complications including OLTrelated acute renal failure in 12 cases (32.4%).Preoperative blood total bilirubin concentration,volume of preoperative ascites,value of preoperative creatine，value of preoperative PT had significant difference between ARF group and nonARF group.The volume of intraoperative bloodloss,volume of intraoperative blood transfusion，duration of anhepatic phase and duration of operative phase had significant difference between two groups. Conclusion:The etiology of ARF following OLT is multifactorial，with preoperative，intraoperative and postoperative factors being involved.Renal function can be recoveried in the most of patients by allaround treatment.But in some times，CRRT is the effective management for recovery of kidney function.

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Methods of removing metallic foreign body from human body soft tissue: a review of 7 390 cases FAN Jun,XING Guang-fu,QIN Xian-ju,et al. 2007, 27(04): 1-291.  Abstract ( )   PDF (300KB) ( )   Objective:To study the methods of locating the metallic foreign body in soft tissue of human body. Methods:With three dimensional locator,the metallic foreign bodies were removed precisely from soft tissue of 7390 patients through magnetism corresponding forceps (both were nationality inventive patent) between June 1996 and June 2006. Results:In 7 390 patients,99.5% of all the foreign bodies were successfully removed by threedimensional locator and forceps.The mean operation time was five minutes. Conclusion:Using the method,the metallic foreign body can be located precisely and removed simply with little complications.They are characterized with minor trauma,less pain and higher successful rate.

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BCSG1 expression on prognosis of breast cancer WU Ke-jin,QUAN Zhi-wei,WENG Zi-yi,et al. 2007, 27(04): 1-273.  Abstract ( )   PDF (413KB) ( )   Objective:To detect breast cancer specific gene 1 (BCSG1) expression in breast cancer,analysis its correlation with clinical parameters and evaluate the effect of BCSG1 expression on prognosis of breast cancer. Methods:The expression of BCSG1 was detected by reverse transcriptionpolymerase chain reaction (RT-PCR) in surgical specimens from 93 cases of breast cancer patients selected randomly between September 1999 and May 2003 at Xinhua Hospital,Shanghai Jiaotong University School of Medicine.The correlation between BCSG1 gene expression and clinical parameters of breast cancer was analyzed.Ninetythree cases of breast cancer were followed up (11-75 months) to set up independent prognosis factor by survival analysis. Results:BCSG1 was detected in 36.6% of all breast cancer samples (34/93).76.5% (26/34) of BCSG1positive cases was stage Ⅲ/Ⅳ.The expression of BCSG1 was tightly correlated with the stage (P=0.000) and the lymph nodes (P=0.036).The median survival time of BCSG1positive cases was 67.5 months.Three years and 5 years disease free survival rate was 78.8% and 36.3% respectively.BCSG1positive cases showed significantly poorer prognosis than that of the BCSG1negative cases (P=0.043).Both BCSG1（P=0.039）and PR（P=0.038）were the independent prognosis factors of breast cancer. Conclusion:The expression of BCSG1 is closely correlated to the stage of breast cancer and the lymph nodes metastases status. BCSG1 may be a new prognosis factor of breast cancer.

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Retroperitoneal liposarcoma: a study of biological characteristics and strategy of diagnosis and treatment GUO Pengtao,XU Yingying,LU Chong,et al. 2007, 27(04): 1-291.  Abstract ( )   PDF (421KB) ( )   Objective:To study the biological behavior and strategy of diagnosis and treatment of retroperitoneal liposarcoma. Methods:The clinical and pathological data of 32 patients with primary and recurrent retroperitoneal liposarcoma admitted in the First Affiliated Hospital of China Medical University between 1970 and 2005 (received 43 operations aggregately) were analyzed retrospectively. Results:The most common clinical manifestations were abdominal distension,growing and palpable abdominal mass.Compared with primary cases,recurrent cases had the following characteristics:the worse biological behaviors,stronger tumor invasive power,higher grade of histologic subtypes and the less complete resection.The interval without tumor burden turned shorter after multiple recurrences.Refractory hemorrhage was the major and lethal complication after operation. Conclusion:Although recurrence is common after resection,surgical resection is still the most effective treatment for retroperitoneal liposarcoma.The more complete resection patients receive,the longer interval without tumor burden patients have.Avoiding refractory hemorrhage is the key point to diminish mortality after operation.Radiotherapy and chemotherapy have limited effect on retroperitoneal liposarcoma.