Influencing Factors Of Recurrence Research Articles

Clinicopathological analysis of 285 cases of elderly patients with epithelial ovarian cancer.

e17539 Background: Elderly patients with epithelial ovarian cancer often cannot receive standard treatment, and their survival time decreases with age, seriously threatening their lives. Elderly patients with epithelial ovarian cancer tend to have many complications and poor tolerance to surgery and chemotherapy, resulting in poor overall prognosis. Methods: The clinicopathological data of EOC patients aged ≥ 60 years old who were diagnosed and treated in our hospital from January 2013 to January 2018, with completed clinical and pathological data were collected for analysis and followed up through outpatient review, telephone, WeChat, QQ group, etc. to analyze the diagnosis and treatment plan and main prognostic factors. The deadline for follow-up was March 1, 2020. Results: Comparison of recurrence and the overall survival in different groups, the results respectively showed that the difference had statistically significant (χ2 = 255.027, p < 0.001) 、(χ2 = 314.443, p < 0.001). Analysis of the factors affecting the recurrence and death of patients showed that the results of single factor analysis showed age, BMI, Combined with cardiovascular and cerebrovascular diseases, pre-treatment CA125 value, thrombus score, FIGO staging, pathological type, residual lesion size are the influencing factors of recurrence. Further multivariate analysis showed that combined cardiovascular and cerebrovascular diseases, pre-treatment CA125 value, FIGO stage, residual lesion size is an independent factor affecting relapse. The median survival time of relapse-free in the neoadjuvant chemotherapy group was 39.00 (30.67̃44.95) months; the median survival time of relapse-free in the directing surgery group was 36.00 (29.47̃42.53) months, statistical comparison showed no significant difference (χ2 = 2.426, p = 0.119). The total median survival time of the neoadjuvant chemotherapy group was 49.57 months; for the directing surgery group, the total median survival time was 47.07 months, and the statistical comparison showed no significant difference (χ2 = 0.166, p = 0.684). Conclusions: For the epithelial ovarian cancer in elderly patients the results showed that the standard treatment group was better than the non-standard treatment group, chemotherapy-only group, surgery-only group, and untreated group. Comparing with primary tumor debulking surgery (PDS),neoadjuvant chemotherapy-Interval debulking surgery (NACT-IDS) group could improve the intraoperative situation，reduce the amount of intraoperative bleeding, shorten the operation time, reduce the wound healing rate and the incidence of surgical complications, but it had no effect on the tumor removal rate, PFS and OS.

Factors that may affect recurrence of trigeminal neuralgia after percutaneous balloon compression

ObjectiveTo investigate the efficacy of percutaneous balloon compression of the Gasserian Ganglion (PCGG) in the treatment of trigeminal neuralgia(TN)and the influencing factors of recurrence after PCGG. MethodsThe clinical data of 221 patients with TN treated by PCGG were retrospectively analyzed and followed-up to explore the postoperative efficacy. ResultsThere were 158 cases of immediate disappearance of pain and 59 cases of delayed pain disappearance in patients after one PCGG operation, for an overall efficacy rate of 98.2%. Forty-nine patients experienced recurrence of pain, for a recurrence rate of 22.6%, and average recurrence time of 18 months. The effective rate of medication in patients with recurrent trigeminal neuralgia is 85.7%.Univariate and multivariate logistic regression analyses showed that hypertension disease and delayed pain disappearance were independent factors for recurrence. The incidence of inhibitory reaction of the trigeminal nerve during the operation was 97.3%. The most common postoperative complications were facial numbness, masticatory-muscle weakness, tinnitus, diplopia and keratitis, which occurred at rates of 76.9%, 28.1%, 14.5%, 11.8% and 10.4%, respectively. All of the complications resolved within 3 years after PCGG. ConclusionsPCGG is a safe and effective surgical method for the treatment of TN. The pain in most patients disappeared after surgery, leaving sequelae such as facial numbness, masticatory-muscle weakness and tinnitus. The mean time to recurrence of postoperative pain was 18 months, with hypertension disease and delayed pain disappearance as associated factors.

Analysis on Influencing Factors of Recurrence after Indirect Inguinal Hernia Laparoscopic Surgery.

This paper aims to analyze the recurrence of indirect inguinal hernia in children after laparoscopic surgery and investigate the influencing factors that may lead to recurrence so as to guide the prevention and treatment of postoperative recurrence of this kind of disease in the future. The data of 260 children with indirect inguinal hernia treated by laparoscopic surgery and followed up in our hospital from July 2019 to July 2021 were selected. A self-designed questionnaire was used to collect the basic data. The recurrence was analyzed, and the influencing factors of recurrence were analyzed by univariate analysis and multivariate analysis. Among 400 children after indirect inguinal hernia laparoscopic surgery, an occurrence was observed in 15 children, and the recurrence rate was 5.77%. Univariate analysis showed that the age and course of disease were not correlated with recurrence after indirect inguinal hernia laparoscopic surgery (P > 0.05). Being male, bilateral lesions, exact high ligation, loose hernia back wall peritoneum, deciduous ligature, incorrect ligation of the fascia of musculus obliquus externus abdominis, large inguinal hernia, circumferential wiring, and too early off-bed activity were the influencing factors of recurrence after indirect inguinal hernia laparoscopic surgery (P < 0.05). Logistic multivariate regression analysis showed that being male, bilateral lesions, loose hernia back wall peritoneum, deciduous ligature, incorrect ligation of the fascia of musculus obliquus externus abdominis, large inguinal hernia, and too early off-bed activity were the influencing factors of recurrence after indirect inguinal hernia laparoscopic surgery (OR>1, P < 0.05). Exact high ligation and circumferential wiring were protective factors of recurrence after indirect inguinal hernia laparoscopic surgery (OR>1, P < 0.05). After indirect inguinal hernia laparoscopic surgery, recurrences were affected by many factors, such as gender, site of pathological changes, and loose hernia back wall peritoneum. For these children with risk factors, reasonable intervention should be taken to reduce recurrence; exact high ligation and circumferential wiring are the protective factors. If permitted, the children meeting related indications can be treated by high ligation or circumferential wiring to reduce the risk of recurrence after indirect inguinal hernia laparoscopic surgery.

Analysis of prognostic factors in 171 patients with myxofibrosarcoma of the trunk and extremities: a cohort study.

BackgroundMyxofibrosarcoma (MFS) of the trunk and extremities has unique clinical features. However, it is not clear which indicators are the influencing factors of recurrence, metastasis, and survival of trunk and limb MFS. The aim of the present study was to analyze clinical features and prognosis of trunk and limb MFS.MethodsThe data of 171 patients with MFS of the trunk and extremities and a median follow-up period of 67 months from January 1999 to July 2018 were retrospectively analyzed. Risk factors for survival, recurrence and metastasis following resection of MFS of trunk and extremities were analyzed. The Kaplan-Meier method (log-rank test) was used for the univariate analysis and a Cox regression model was used for the multivariate analysis.ResultsThe median age of the patients was 53 years; there were 111 males and 60 females. A total of 132 cases had French Federation of Cancer Centers grade 1, 24 cases had grade 2, and 15 cases had grade 3 MFS. The 3-year recurrence, 3-year metastasis, and 5-year survival rates were 29.2%, 19.3%, and 93.6%, respectively. Kaplan-Meier survival analysis showed that the surgical margin (χ2=22.228, P<0.001) and tumor size (χ2=6.697, P=0.010) were associated with recurrence. The surgical margin (χ2=12.353, P<0.001) and CD44 expression (χ2=5.227, P=0.022) were associated with metastasis. The multivariate analysis showed that the surgical margin [hazard ratio (HR) =3.635, 95% confidence interval (CI): 1.883–7.016, P<0.001] and tumor size (HR =1.889, 95% CI: 1.039–3.435, P=0.037) were risk factors for local recurrence. In addition, the surgical margin (HR =4.475, 95% CI: 1.918–10.438, P=0.001) and presence of CD44 (HR =3.406, 95% CI: 1.462–8.405, P=0.005) were risk factors for distant metastasis.ConclusionsA negative surgical margin can be reduced effectively the rate of recurrence and metastasis in patients with MFS of the trunk and limbs. In addition, CD44 may be used to assess the metastatic risk of patients with MFS.

18F-FDG PET/CT Associates With Disease Activity and Clinical Recurrence of AOSD Patients.

Objective: The purpose of this study was to explore the value of 18F-FDG PET/CT in monitoring the disease activity and predicting the prognosis of the Adult-onset Still's disease (AOSD).Methods: We retrospectively analyzed the electronic medical records of 45 AOSD patients who underwent 18F-FDG PET/CT in the Second Xiangya Hospital. PET/CT imaging and clinical information were retrospectively reviewed and analyzed. 18F-FDG uptake was assessed by measuring standard uptake value (SUV) in the spleen, liver, bone marrow, and lymph nodes. The spleen-to-liver ratio of the SUVmax (SLRmax) and SUVmean (SLRmean), the bone-to-liver ratio of the SUVmax (BLRmax), and SUVmean (BLRmean), and the lymph nodes-to-liver ratio of the SUVmax (LyLRmax) were calculated. Clinical and laboratory information were collected and evaluated for association with metabolic parameters of 18F-FDG PET/CT. The influencing factors for recurrence within 1 year were analyzed to determine whether 18F-FDG PET/CT can predict the prognosis of AOSD patients.Results: Elevated 18F-FDG uptake could be observed in bone marrow, spleen, and lymph nodes of AOSD patients. Correlation analysis between 18F-FDG uptake of organs and laboratory examinations showed that SLRmean positively correlated with LDH, AST, ferritin, and the systemic score (r = 0.572, 0.353, 0.586, and 0.424, P < 0.05). The SLRmean had the highest correlation with ferritin (r = 0586, P < 0.001). All metabolic parameters in spleen, including SUVmax, SUVmean, SLRmax, and SLRmean, are positively correlated with LDH level (r = 0.405, 0.539, 0.481, and 0.572, P < 0.05). Bone marrow SUVmax, BLRmax, and BLRmean were correlated with C-reactive protein (CRP) level (r = 0.395, 0.437, and 0.469, P < 0.05). Analysis of the influencing factors of recurrence within 1 year showed that the spleen SUVmax, spleen SUVmean, SLRmax, SLRmean, ferritin, and the systemic score of the recurrence group was significantly higher than the non-recurrence group (P < 0.05). The SLRmean cutoff of 1.66 with a sensitivity of 72.7% and specificity of 80.0% had the highest performance in predicting recurrence.Conclusion: The glucose metabolism of the liver, spleen, and bone marrow of AOSD patients were correlated with laboratory inflammatory indicators and system score, suggesting that 18F-FDG PET/CT could be applied to evaluate disease activity. Moreover, spleen 18F-FDG uptake may be a potential biomarker for predicting clinical prognosis of AOSD patients.

Adnexal Torsion Recurrence - Is the Degree of Adnexal Twist a Risk Factor?

Study Objective To determine whether the adnexal twist degree is related to torsion recurrence and whether there is a dose-dependent relationship. Design Cases of first ovarian torsion that were diagnosed operatively in non-pregnant women between 3.2011-8.2018 were collected retrospectively. The study was performed in a single tertiary care center. Information regarding recurrence was gathered using computerized database. Patients with missing data were approached via phone (response rate of 87.2%). Setting N/A Patients or Participants 336 cases were found, of them 195 met inclusion criteria. Interventions N/A Measurements and Main Results Twenty-two women had torsion recurrence (11.3%). In a univariate analysis, adnexal twist degree in the primary event was associated with a higher risk for recurrence: 4.3% of women with twist degree ≤360 (N=3/70), 14.5% of women with twist degree of 361-720 (N=9/62) and 19.6% of women with twist degree >720 (N=10/51) (P value=0.029). That association was observed in a Mann-Whitney analysis as well, as median twist degree among women without torsion recurrence was 540 (N=173, IQR 360-900) versus 720 among women with recurrence (N=22, IQR 675-1080) (P value=0.005). Other possible influencing factors for recurrence were evaluated, such as adnexal size, presence of a cyst, polycystic ovaries, adnexal color, presence of adhesions and contraceptives use, none were found significant. Logistic regression analysis after adjustment for confounding factors revealed that adnexal twist degree remained significantly associated with higher rates of torsion recurrence (OR 2.06, 95% CI 1.11-3.84, P value=0.022). Conclusion Adnexal twist degree in ovarian torsion might be correlated to risk of ovarian torsion. Further studies with bigger cohorts are needed.

Analysis of influencing factors of recurrent spontaneous pneumothorax in adolescents after closed thoracic drainage

Objective To explore the influencing factors of recurrent spontaneous pneumothorax after thoracic closed drainage in adolescents. Methods From January 2010 to May 2018, 62 young patients with spontaneous pneumothorax treated in School Hospital of Zhejiang Ocean University and referral to superior hospital were selected.The patients were followed up by telephone or clinic for 24 months after discharge, and their general information and recurrence were collected.Logistic regression multivariate analysis was used to investigate the influencing factors of recurrent spontaneous pneumothorax after thoracic closed drainage in adolescents. Results Sixty-two patients were followed up, 15 patients with recurrence, and the recurrence rate was 24.19%.Univariate analysis showed that age over 20[recurrence and non-recurrence ≤20 years old 11 cases (73.33%), 11 cases (23.40%); >20 years old 4 cases (26.67%), 36 cases (76.59%)], body mass over 19.6kg/m2[recurrence and non-recurrence BMI ≤19.6 10 cases (66.67%), 18 cases (38.30%); BMI>19.6 5 cases (33.33%), 29 cases (61.70%)], smoking[recurrence and non-recurrence smoking 12 cases (80.00%), 14 cases (29.79%); non-smoking 3 cases (20.00%), 33 cases (70.21%)], degree of pneumobula lesions[recurrence and non-recurrence mildly 3 cases (20.00%), 19 cases (40.43%); medium 5 cases (33.33%), 20 cases (42.55%); severe 7 cases (46.67%), 8 cases (17.02%)], pneumothorax[recurrence and non-recurrence a little 2 cases (13.33%), 20 cases (46.81%); massive 13 cases (86.67%), 27 cases (53.19%)] and diameter of pneumobula over 1cm[recurrence and non-recurrence ≤1cm 5 cases (33.33%), 28 cases (61.70%); >1cm 10 cases (66.67%), 18 cases (38.29%)] were associated with recurrence after closed thoracic drainage (χ2=11.857, 5.192, 9.325, 13.522, 9.824, 6.823, all P<0.05). The results of logistic multivariate regression analysis showed that age(OR: 1.224; 95% CI: 0.958-12.142), BMI(OR: 3.463; 95% CI: 0.824-9.024), smoking(OR: 5.000; 95% CI: 1.534-9.852), degree of pneumobulus lesions(OR: 12.041; 95% CI: 6.032-12.174) and pneumothorax(OR: 2.465; 95% CI: 1.627-4.684) were the influencing factors for recurrence after primary spontaneous pneumothorax drainage in adolescents (all P<0.05). Conclusion Younger than 20 years of age, smoking, pneumobulous lesions and large pneumothorax are risk factors for recurrence after primary spontaneous pneumothorax drainage. Key words: Teenagers; Pneumothorax; Closed drainage of thoracic cavity; Recurrence; Logistic models; Factor analysis, statistical

Primary spinal pilocytic astrocytoma: clinical study with long-term follow-up in 16 patients and a literature review.

Primary pilocytic astrocytoma (PA) of the spine is extremely rare and most published case series only include only a few patients. We attempted to explore the clinical features, radiological findings, and treatment outcomes of patients with spinal PA. Sixteen spinal PA patients who were surgically treated in our hospital between April 2008 and June 2018 were included in this retrospective study. An integrative analysis was performed regarding spinal PA patients by extracting from published studies on PubMed. The 16 patients with spinal PA included eight male and eight female patients with a mean age of 29.1years. Ten cases (62.5%) had masses located in the cervical segments, five (31.3%) had masses in the thoracic segments, and one (6.2%) had masses in the sacral canal. All the patients were treated surgically with 13 gross total resections (GTRs, 81.3%) and three subtotal resections (STRs). The mean follow-up period was 40.4months. These tumors accounted for a recurrence rate of 37.5% (6 of 16 patients) and no death during the follow-up periods. The influencing factors of recurrence were mainly STR, gene mutation (NF-1 and H2-K27M), and the number of segments involved. The mean recurrence-free survival duration was 19months. The imaging features of spinal PA are heterogeneous, and the definitive diagnosis requires pathological support. GTR is the standard therapy for spinal PAs, although patients with GTR are still likely to relapse. The regular spinal magnetic resonance imaging follow-ups are required regardless of the resection status. Reoperation is feasible for patients with recurrence.

Treatment outcomes of endoscopic pancreatic sphincterotomy combined with pancreatic duct stent for acute recurrent pancreatitis caused by biliary microlithiasis

Objective To investigate the clinical efficiency of endoscopic pancreatic sphincterotomy (EPS) combined with pancreatic duct stent for acute recurrent pancreatitis (ARP) caused by biliary microlithiasis. Methods A total of 71 patients were diagnosed as having ARP resulting from biliary microlithiasis from April 2005 to November 2016, and their clinical data were retrospectively analyzed. Patients were divided into two groups according to different endoscopic therapy, EPS (n=34) and EST group (n=37), respectively. The rate of pancreatitis recurrence, post-ERCP pancreatitis (PEP) and biliary complications were compared by Chi-square test and the influencing factors of recurrence were evaluated by survival analysis. Results The follow-up time ranged from 2 to 108 months (median 21.5 months) in EPS group and ranged from 5 to 120 months (median 39 months) in EST group. Twelve months after endoscopic therapy, 2 patients in EPS group and 5 in EST group suffered recurrent pancreatitis(χ2=0.461, P=0.497). Recurrence occurred in 13 patients in 60 months after endoscopic therapy, 4 patients in EPS group and 9 in EST group. Cox regression analysis indicated different endoscopic treatment (RR=6.808, 95%CI: 1.389-33.356, P=0.018) and type 2 diabetes (RR=0.134, 95%CI: 0.029-0.608, P=0.009) were statistically significant factors. There were no significant difference in incidence of PEP (20.6% in EPS group, 10.8% in EST group, χ2=1.294, P=0.255) and biliary complications between two groups (11.8% in EPS group, 24.3% in EST group, χ2=1.869, P=0.172). Conclusion EPS combined with pancreatic stenting is effective for acute recurrent pancreatitis caused by microlithiasis. Type 2 diabetes may also lead to recurrence of acute pancreatitis. Key words: Pancreatitis; Biliary microlithiasis; Endoscopic pancreatic sphincterotomy; Endoscopic sphincteropapillotomy

Antithyroid Drug Therapy for Graves' Disease and Implications for Recurrence.

Graves' disease (GD) is the most common cause of hyperthyroidism worldwide. Current therapeutic options for GD include antithyroid drugs (ATD), radioactive iodine, and thyroidectomy. ATD treatment is generally well accepted by patients and clinicians due to some advantages including normalizing thyroid function in a short time, hardly causing hypothyroidism, and ameliorating immune disorder while avoiding radiation exposure and invasive procedures. However, the relatively high recurrence rate is a major concern for ATD treatment, which is associated with multiple influencing factors like clinical characteristics, treatment strategies, and genetic and environmental factors. Of these influencing factors, some are modifiable but some are nonmodifiable. The recurrence risk can be reduced by adjusting the modifiable factors as much as possible. The titration regimen for 12–18 months is the optimal strategy of ATD. Levothyroxine administration after successful ATD treatment was not recommended. The addition of immunosuppressive drugs might be helpful to decrease the recurrence rate of GD patients after ATD withdrawal, whereas further studies are needed to address the safety and efficacy. This paper reviewed the current knowledge of ATD treatment and mainly focused on influencing factors for recurrence in GD patients with ATD treatment.

Study on correlation indexes with recurrence of acquired thrombotic thrombocytopenic purpura during the first remission

Objective To study the relationship between recurrence of acquired thrombotic thrombocytopenic purpura (TTP) patients in their first remission period and expression levels of a disintegrin and metallopeptidase with thrombospondin motif (ADAMTS)13 and anti-ADAMTS13 antibody. Methods From March 2008 to June 2014, a total of 37 patients with acquired TTP who were treated in Affiliated Hospital of Yan′an University and Fuping County Hospital of Weinan City in Shaanxi Province were included in this study. According to whether relapse at the first time in follow-up period, they were divided into study group (n=15) and control group (n=22). Residual collagen binding assays, ELISA, Western blotting method were used to detect the ADAMTS13 activity, levels of ADAMTS13 antigen, anti-ADAMTS13 antibody, ADAMTS13 inhibitor, von Willebrand factor (vWF) antigen and ultralarge von Willebrand factor (ULVWF), respectively. The above indexes between two groups were compared by statistical methods. Multivariate unconditional logistic regression analysis was used to evaluate the independent influencing factors of recurrence in acquired TTP patients during their first remission. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of hospitals above. Informed consent was obtained from all participants. Results ① The median plasma ADAMTS13 activity of study group was 11% (7%~124%), which was lower than that of 53%(7%~151%) in control group, and there as significance difference between two groups (u=4.018, P<0.05). Plasma ADAMTS13 activity remarkably reduced percentage was 53.3%(8/15) in study group, which was higher than that of 22.7%(5/22) in control group, the differences was statistically significant (P=0.049). ② Plasma ADAMTS13 activity level of all 37 patients with acquired TTP was positively correlated with plasma ADAMTS13 antigen level (rs=0.810, P=0.001). The median plasma ADAMTS13 antigen level of study group was 33% (3%~99%), which was lower than that of 59% (3%~128%) in control group, and there was significance difference between two groups (u=4.121, P<0.05). Remarkably reduction percentage of plasma ADAMTS13 antigen level was 13.3%(8/15) of study group, which was much higher than that of 9.1% (2/22) in control group, the differences was statistically significant between two groups (P=0.008). ③ The detection rate of plasma anti-ADAMTS13 antibody of study group was 66.7% (10/15), which was higher than that of 36.4% (8/22) in control group, and the difference was statistically significant (P=0.007). ④ The detection rate of plasma anti-ADAMTS13 inhibitors of study group was 46.7% (7/15), which was higher than that of 18.2% (4/22) in control group, and the difference was statistically significant (P=0.011). ⑤ In study group, detection rate of ULVWF polymer was 20.0% (3/15), which was much higher than that of 13.6% (3/22) in control group, and the difference was statistically significant between the groups (P=0.042). ⑥ Analyzed correlation indexes by multivariate unconditional logistic regression analysis showed that the independent risk factors affected recurrence of acquired TTP patients during the first remission including, plasma ADAMTS13 activity remarkably reduced (OR=2.95, 95%CI: 1.13-6.96, P<0.05), presence of plasma anti-ADAMTS13 antibody (OR=3.31, 95%CI: 1.08-8.19, P<0.05), and presence of plasma anti-ADAMTS13 inhibitor (OR=3.24, 95%CI: 1.24-9.03, P<0.05). Conclusions For acquired TTP patients druing first remission period, the remarkably reduced of ADAMTS13 activity level, presence of anti-ADAMTS13 antibody and anti-ADAMTS13 inhibitor could significantly increase the risk of recurrence, which could be used as important indicators for predicting recurrence of acquired TTP patients during the first remission. Key words: Purpura, thrombotic thrombocytopenic; ADAMTS13 protein, human; Von Willebrand factor; Recurrence

Influencing factors of recurrence of fracture after percutaneous vertebral augmentation

Objective To evaluate the influencing factors of recurrence of fracture after percutaneous vertebral augmentation. Methods From January 2007 to December 2013, 256 cases patients with percutaneous vertebral augmentation in treatment of osteoporotic vertebral compression fractures in the Central Hospital of Chaoyang were retrospectively reviewed.After operation, the patients were divided into recurrent fracture group(59 cases) and no recurrence group(197 cases) according to whether postoperative recurrence of vertebral fracture.The age, sex, body mass index(BMI), bone mineral density, operation mode, bone cement injection volume, the existence of bone cement leakage and vertebral body height recovery rate were compared between the two groups respectively.Multi factor Logistic regression analysis was performed to analyze the correlation between the factors and the recurrence of vertebral body fractures. Results The age((75.9±4.6) years old vs. (69.9±5.0) years old), BMI((23.5±0.6) kg/m2 vs. (25.4±0.7) kg/m2), bone mineral density((-3.67±0.68) vs. (-2.75 ±0.98)), the existence of bone cement leakage rate(22.0% vs. 5.1%) and vertebral body height recovery rate((24.1±2.9)% vs. (14.9±3.0)%) between recurrent fracture group and no recurrence group had statistically significant differences(P=0.046, 0.047, 0.046, 0.026, 0.023). Multi factor Logistic regression analysis showed that age, BMI were not related to postoperative recurrence of fracture(P=0.140, 0.137), and bone density, bone cement leakage and vertebral body height recovery rate were related to recurrence of fracture(P=0.018, 0.000, 0.000). Conclusion Low bone mineral density, existence of bone cement leakage and high body height recovery rate are the risk factors of recurrence of fracture after percutaneous vertebral augmentation. Key words: Thoracic and lumbar vertebrae fracture; Percutaneous vertebral angioplasty; Percutaneous kypho-plasty; Recurrence of vertebral fracture; Bone mineral density; Bone cement leakage; Vertebral body height recovery rate

Influencing elements and treatment strategies associated with the relapse of hepatocellular carcinoma after surgery.

Long-term prognosis after surgical resection of Hepatocellular Carcinoma remains unsatisfactory, mainly because of the high postoperative incidence of recurrence and metastasis. An updated knowledge on the influencing factors of recurrence and treatment strategies of postoperative recurrence is important for clinicians in designing a strategy to optimize the chance of long-term survival in patients undergoing hepatic resection for HCC. Using key words “Hepatocellular Carcinoma”, “liver cancer”, “resection”, “postoperative recurrence”, “treatment strategy”, “therapy”, “influencing factors”, “risk factors”, we performed a review of relevant English articles based on based on a Medline search before May 2012. Influencing factors include tumor size, venous invasion, satellite nodules, cirrhosis, alpha-foetoprotein, aspartate aminotransferase, alkaline phosphatase levels, hepatitis B virus and hepatitis C virus infection, Alpha-foetoprotein mRNA and some surgical factors. Treatment strategies include re-resection, transarterial chemoembolization, radiofrequency ablation, percutaneous ethanol injection, salvage liver transplantation, radioactive seed 125I implantation and other new treatment modalities of postoperative recurrent HCC are all used to prolong survival in patients with recurrence, and multimodality therapy of above mentioned therapies may offer additional benefit. With advances in perioperative detection and therapeutic modalities, results of recurrence after resection of HCC will greatly improved.