Postoperative Treatment Of Patients Research Articles

Clinical effects of IPCH after the surgery for ovarian cancer at the middle or advanced stage and its impacts on tumor markers and immune functions.

To evaluate the clinical effects of intraperitoneal chemohyperthermia (IPCH) in the treatment of postoperative patients with advanced stage ovarian cancer, and its impacts on tumor markers and immune functions. This is a retrospective study. One hundred and twenty patients with advanced stage ovarian cancer received in Shanghai 7th People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from May 10, 2022 to June 10, 2023 were selected and randomly divided into control and study groups (n=60 each group). Patients in the control group were administered routine intravenous chemotherapy, the study group underwent IPCH besides routine intravenous chemotherapy based on the control group. Comparatively analyzed the clinical effects, adverse reaction occurrence rates, and variations in relevant observation targets, the tumor marker after and before the treatment. Total efficacy in the study and control groups are proved to be with statistically significant differences. The occurrence of adverse reactions proved that no significant differences is seen between both groups. After the treatment, CEA, CA19-9, and CA125 levels in patients of the study group are apparently lower than those in the control group, showing statistically significant differences; expression levels of CD3+, CD4+ and CD4+/CD8+, in the study group were enormously above those in the control group after the treatment, with statistically significant differences. IPCH has the potential to effectively enhance comprehensively clinical therapeutic effects among postoperative patients with ovarian cancer, significantly improve patients' immune states, and evidently reduce expression levels of various tumor markers.

Application of Non-Pharmacologic Therapy in Hair Loss Treatment and Hair Regrowth.

Alopecia significantly affects the appearance and psychology of patients, and pharmacological therapies and hair transplantation are the main treatments for alopecia, but both have limitations. This review aimed to summarize the non-pharmacological therapies that promote hair growth and regeneration. This is a non-systematic review. Multiple databases was searched with relevant data published between 1997 and 2024. Searching and screening followed the PRISMA guidelines. Novel therapeutic modalities, such as gas molecules, platelet-rich plasma, laser, and microneedling, can change the microenvironment of hair follicles, activate hair follicle stem cells, and promote hair growth and regeneration. This paper reviews research on the application of non-pharmacological therapies in alopecia treatment and hair regeneration, with a view to providing an important basis for future research on alopecia treatment and the postoperative treatment of patients after hair transplantation.

The efficacy and safety of tislelizumab combined with gemcitabine plus cisplatin in the treatment of postoperative patients with muscle-invasive upper tract urothelial carcinoma

BackgroundA combination of immune checkpoint inhibitors (ICIs) and chemotherapy has demonstrated excellent clinical efficacy and safety in treating a variety of cancers, including urothelial carcinoma (UC). However, its efficacy and safety in patients with muscle-invasive upper tract urothelial carcinoma (UTUC) who are undergoing radical surgery remain uncertain. The purpose of this retrospective study was to examine the effectiveness and safety of tislelizumab combined with gemcitabine plus cisplatin (TGC) as a first-line postoperative adjuvant treatment in this population.MethodsThis single-center, real-world study retrospectively analyzed the data from 71 patients with muscle-invasive UTUC who had radical nephroureterectomy (RNU) at the Affiliated Hospital of Xuzhou Medical University between November 1, 2020, and November 1, 2023. Among the 71 patients, 30 received adjuvant therapy of TGC within 90 days after RNU and 41 underwent surveillance. No patients receive preoperative neoadjuvant therapy. The TGC therapy group received adjuvant therapy every 3 weeks postoperatively until the first recurrence, first metastasis, or death due to any reason, whichever occurred first. The patients were followed up telephonically and through outpatient visits to record and evaluate their disease-free survival (DFS) and treatment-related adverse events (TRAEs).ResultsThis study assessed the DFS of 41 and 30 patients in the surveillance group and TGC therapy group, respectively. The median DFS of the surveillance group was 16.5 [95% confidence interval (CI), 14.7–18.3] months, while the median DFS of the TGC group has not yet reached [hazard ratio (HR) 0.367 (95% CI, 0.169–0.796); p = 0.008], with 21 patients still undergoing follow-up. Compared with the surveillance group, the TGC therapy group had dramatically improved DFS after RNU and reduced risk by 63.3%. Of the 30 patients receiving combination therapy, 28 experienced TRAEs; all TRAEs were consistent with the frequently reported events in the chemotherapy-alone regimens, and there were no treatment-related deaths.ConclusionThis study demonstrates that TGC therapy exhibits excellent clinical efficacy in patients undergoing radical surgery, significantly improving DFS and displaying great safety.

Oralno hirurško zbrinjavanje pacijenata obolelih od hemofilije

Introduction: Haemophilia is one of the most common haemorrhagic diseases from the group of coagulopathies and results from a deficiency of factors responsible for the first phase of coagulation. Aim: This informative paperwork aims to highlight the principles of oral surgical treatment of patients with haemophilia. Material and methods: The available literature was analysed to indicate the basic characteristics of haemophilia (clinical manifestation, possibilities of treatment and prophylaxis of the disease) with special reference to specificity and principles of dental oral surgical treatment of patients with haemophilia. Conclusion: The treatment of patients with haemophilia is considered one of the riskiest in everyday dental practice. Despite this, dental interventions can be successfully and safely performed. However, the dentist must be acquainted with the nature of the disease, its symptoms and the severity of the clinical picture. Furthermore, the dentist needs to know what kind of therapy the patient receives for the treatment of haemophilia, whether the patient has been diagnosed with inhibitors to the coagulation factor, and whether the patient has concomitant diseases with special reference to possible infectious diseases. Along with that, the key to a successful and safe intervention lies in a well-planned preoperative, perioperative and postoperative treatment of patients with haemophilia.

Practice guidelines for management of uterine corpus cancer in Korea: a Korean Society of Gynecologic Oncology consensus statement.

The Korean Society of Gynecologic Oncology (KSGO) had been making an effort to standardize and enhance the quality of domestic uterine corpus cancer treatment by developing updated clinical practice guidelines in 2021. The KSGO revised the guidelines based on a literature search using 4 key elements: Population, Intervention, Comparison, and Outcome framework. These elements include the evaluation of the efficacy and safety of immune checkpoint inhibitor treatment in recurrent/advanced endometrial cancer patients who have failed platinum-based chemotherapy, as well as the effect of combined treatment with trastuzumab in patients with HER2/neu-positive endometrial cancer. Additionally, the guideline assessed the efficacy and safety of omitting lymph node dissection in low-risk endometrial cancer patients, investigated the effect of sentinel lymph node mapping in early-stage endometrial cancer surgery, addressed the outcome of chemoradiation therapy as a postoperative treatment in patients with advanced (stage III-IVA) endometrial cancer, and explored the impact of initial treatment with immune checkpoint inhibitors on survival in patients with advanced or recurrent endometrial cancer patients.

Correlation between the histopathological findings of gallbladder samples and clinical outcomes within the framework of a hybrid study

Background: This study focuses on the histopathological characteristics of benign and potentially malignant lesions of the gallbladder, with a specific emphasis on the efficacy of cholecystectomy as a secondary preventive measure in specific clinical contexts. The aim is to contribute to the development of improved preventive and therapeutic approaches. Methodology: This research study employed a hybrid approach of retrospective and prospective data analysis on cholecystitis during the year 2023. Various variables were analyzed to explore their associations with clinical outcomes. Results: The study included 63 patients, with no statistically significant differences in age between male and female patients. Analysis of the length, width, and thickness of the gallbladder wall did not reveal statistically significant differences (p > 0.05). Correlation analysis showed weak connections between age and gallbladder characteristics. The average recovery time was 4.46 days, and the duration of hospitalization positively correlated with age (p<0.001). Regression analysis indicated an association between symptoms and age and the duration of hospitalization (p = 0.015, p<0.001). Logistic regression demonstrated an accuracy of 61.9%, with high precision in predicting stays longer than 3 days. Chi-square tests confirmed statistically significant differences in histopathological diagnoses related to comorbidities (p = 0.021). Conclusion: Gender-specific approaches in postoperative treatment of patients with gallbladder issues highlight significant differences in patient characteristics, while the analysis of comorbidities reveals a connection between hypertension and pathological changes in the gallbladder.

The effectiveness of flavonoids in the postoperative treatment of patients with hemorrhoids

Evaluation of the effectiveness of flavonoids in the postoperative management of patients with hemorrhoids. A single-center randomized controlled clinical trial was conducted. Patients with stage III and IV hemorrhoids aged over 18 years who patients who underwent hemorrhoidectomy were included. 135 patients were randomized. There were no patients who dropped out of the study. The number of participants whose data were included in the analysis was 65 patients in the main group and 70 patients in the control group. The use of purified micronized flavonoid fraction in the postoperative management of patients with hemorrhoids can significantly reduce the degree and duration of pain, bleeding and tenesmus.

Influence of High-Risk Pathological Factors and their Interaction on the Survival Benefit of Adjuvant Chemotherapy in Stage II Rectal Cancer: A Retrospective Study.

Objectives: We investigated the impact of high-risk factors in stage II (TNM stage) rectal cancer patients to determine whether they benefit from adjuvant chemotherapy after surgery. Additionally, we explored the interaction between high-risk factors and adjuvant chemotherapy. Our study provides refined guidance for postoperative treatment in patients with stage II rectal cancer. Methods: The retrospective study included 570 stage II rectal adenocarcinoma patients who underwent total mesorectal excision surgery at Tianjin Union Medical Center from August 2012 to July 2019. We employed Cox regression models to assess the collected pathological and clinical factors, identifying the risk factors for overall survival (OS) and disease-free survival (DFS). Additionally, we thoroughly examined the interaction between various high-risk pathological factors and postoperative chemotherapy (ACT), including multiplicative interaction (INTM) and additive interaction (RERI). Results: Among the 570 stage II rectal cancer patients in this study, the average age was 62 years, with 58.9% (N=336) of the population being older than 60. Males accounted for the majority at 64.9% (N=370). Age was found to have an impact on whether patients received adjuvant chemotherapy after surgery (P<=0.001).Furthermore, age (HR: 1.916, 95% CI: 1.158-3.173, P=0.011; HR: 1.881, 95% CI: 1.111-3.186, P=0.019), TNM stage (HR: 2.216, 95% CI: 1.003-4.897, P=0.029; HR: 2.276, 95% CI: 1.026-5.048, P=0.043), the number of lymph nodes cleared during surgery (HR: 1.968, 95% CI: 1.112-3.483, P=0.017; HR: 1.864, 95% CI: 0.995-3.493, P=0.045), and lymphovascular invasion (HR: 2.864, 95% CI: 1.567-5.232, P=0.001; HR: 3.161, 95% CI: 1.723-5.799, P<0.001) were identified as independent risk factors for patients' overall survival (OS) and disease-free survival (DFS). Moreover, the interaction analysis, both multiplicative and additive, revealed significant interactions between the number of lymph nodes cleared during surgery and the administration of adjuvant chemotherapy. For OS (HR for multiplicative interaction: 0.477, p=0.045; RERI: -0.531, 95% CI: -1.061, -0.002) and for DFS (HR for multiplicative interaction: 0.338, p=0.039; RERI: -1.097, 95% CI: -2.190, -0.005). Conclusions: This study provides insights into the complex relationship between adjuvant chemotherapy (ACT) and survival outcomes in stage II rectal cancer patients with high-risk pathological factors. The findings suggest that the number of cleared lymph nodes plays a significant role in the efficacy of ACT and underscores the need for individualized treatment decisions in this patient population.

Features of nephrectomy hemodialysis dependent patients. Experience of the regional center

Background. A feature of the postoperative period of patients with end-stage chronic kidney disease (ESKD) after nephrectomy is the need to continue hemodialysis sessions, taking into account the high risk of developing hemorrhagic complications. A significant place in the literature devoted to organ removal surgery is devoted to a discussion of the video endoscopic method, which, as medicine develops, is constantly being improved, modified and noted as one of the promising areas. Open surgical interventions are accompanied by a more severe course. In this connection, the issue of choosing the timing and method of surgical intervention for this group of patients remains relevant.&#x0D; Aim. To evaluate the results of nephrectomy of hemodialysis patients for the period from 2013 to 2023, performed at the Krasnoyarsk Regional Clinical Hospital.&#x0D; Materials and methods. An analysis of 68 cases of nephrectomy was carried out to evaluate the effectiveness of the protocol adopted in the clinic for the management of nephrectomy in hemodialysis patients. The group included 31 (44.6%) men and 37 (55.4%) women. Nephrectomy through the lumbotomy approach was performed in 31 (45.6%) patients, laparoscopic unilateral nephrectomy – in 23 (33.8%) patients, and bilateral laparoscopic nephrectomy – in 14 (20.6%) patients.&#x0D; Results. Patients with ESKD who underwent nephrectomy were divided into 3 groups – emergency, elective open and laparoscopic nephrectomy. The end-stage of chronic kidney disease and the need for hemodialysis sessions are aggravating factors in the peri- and postoperative treatment of patients with a higher risk of developing complications, in order to minimize which the clinic has adopted a specialized protocol for the management of this category of patients, consisting of preoperative preparation, intraoperative and postoperative stages, applied in 89.7% of cases. Open surgical interventions were performed in 31 patients. Laparoscopic bilateral nephrectomy was performed in 14 patients and was carried out exclusively as planned. Laparoscopic monolateral nephrectomy was performed in 23 patients. Indications for surgical intervention in most patients were the presence of a complicated infection against the background of impaired urodynamics of the upper urinary tract, planned kidney transplantation in patients with polycystic disease, diagnosed malignant tumors of the kidney and ureters. The analysis indicates a greater number of hemorrhagic complications during open interventions. The introduction of endovideosurgical nephrectomy and patient management according to a specialized protocol leads to a significant reduction in the incidence of postoperative complications.&#x0D; Conclusion. Surgical minimally invasiveness and the use of a specialized protocol for the management of hemodialysis-dependent patients makes it possible to reasonably expand the indications for planned interventions, reducing the peri- and postoperative risks of a complicated course.

Clinical Efficacy of Bushen Yiqi Fuzheng Decoction Combined with Sunitinib in the Treatment of Postoperative Patients with Renal Cell Carcinoma and Its Influence on Their Immune Function.

This study aimed to investigate the effect of Bushen Yiqi Fuzheng decoction combined with sunitinib on the prognosis, clinical efficacy and immune function of patients with renal cell carcinoma (RCC) after surgery. A total of 120 patients who experienced RCC after surgery were randomly divided into the observation and control groups in this prospective study, with 60 cases in each group. The therapeutic effect, improvement of clinical symptoms, changes of immune function-related indicators and adverse reactions during medication were recorded. The changes in immune cell population, midkine (MK), interleukin 35 (IL-35), hypoxia-inducible factor 2alpha (HIF-2α), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), carcinoembryonic antigen (CEA), osteopontin (OPN), ferritin (FERR) and beta2-microglobulin (β2-MG) levels were measured. The Karnofsky performance status (KPS) score of patients was recorded. The total effective rate of the observation group (95%) was better than that of the control group (85%, p < 0.05). After treatment, the changes of immune function indexes in the control group were not obvious. The indexes related to immune function in the observation group significantly decreased. Significant differences were observed in the cluster of differentiation 3+ (CD3+), cluster of differentiation 4+ (CD4+), cluster of differentiation 8+ (CD8+) and CD4+/CD8+ between the two groups after treatment. The incidence of adverse reactions in the observation group was lower than that of the control group. The KPS of the observation group was higher than that of the control group. Before treatment, no differences were observed in the MK, IL-35, HIF-2α, CEA, OPN, FERR, β2-MG, MMP-9 and TIMP-1 levels between the two groups. After treatment, the levels of the above parameters were lower than those before treatment, especially in the observation group. Bushen Yiqi Fuzheng decoction combined with sunitinib can significantly improve the clinical efficacy and postoperative immune function of RCC patients after surgery and down-regulate MMP-9 and TIMP-1 levels in the serum, which is beneficial to the prognosis of patients.

Various Postoperative Medical Lines for Management of Allegic Fungal Rhinosinusitis (Meta-Analyical Study)

Abstract Background Allergic fungal rhinosinusitits (AFRS) is a subset of polypoid chronic rhinosinusitis that is characterized by the presence of eosinophilic mucin with fungal hyphae within the sinuses and a type I hypersensitivity to fungi. The treatment of allergic fungal rhinosinusitis usually involves surgery in combination with medical therapies to keep the disease in a dormant state. However, what constitutes an optimal post-operative medical regimen is still controversial. Hence, the purpose of this study is to assess the efficacy of various postoperative medical lines for management of AFRS. Objective To find out the role and efficacy of various medical therapies for postoperative treatment of allergic fungal rhinosinusitis (through a systematic review study). Materials and Methods Fifty studies were included in the present systematic review and meta-analysis, the total number of patients included in all studies (No = 1,655 patients). Our review has investigated the literature on 5 medical therapies (steroids, antifungal, immunotherapy, mepolizumab, and omalizumab) concerning the management of postoperative AFRS patients. Results The results showed that the recurrence rate after postoperative systemic steroids was 26.3%, topical steroids was 38.4%, antifungals therapy was 32.1%, immunotherapy was 17.4%, the percentage of recurrence after combination of antifungal and steroids was 9.6%, recurrence risk difference between antifungal and placebo was 18.2%, recurrence risk difference between steroids and placebo was 6.5%. Base on the above results, the combination of steroids and antifungal therapy is the best treatment for postoperative patients with AFRS. Conclusion This review investigated the literature on 5 medical therapies (steroids, antifungal, immunotherapy, mepolizumab, and omalizumab) concerning the management of postoperative AFRS, and provided an evidence-based review with recommendations, the use of steroids alone or antifungals as well, resulted in some degree of recurrence reduction in disease, the evidence supports the use of postoperative combination (oral steroids and systemic antifungal) as a better line of post-operative medical treatment in AFRS patients.

The effect of enteral nutrition nursing intervention on postoperative treatment of chronic critically ill patients: Health prevention data analysis

The field of genomics has witnessed remarkable advancements, leading to the gradual clarification of the genetic mechanism underlying various cancers. As a result, there has been an increased emphasis on gene prevention and treatment. Against this backdrop, this paper aims to examine the impact of enteral nutrition nursing intervention on the postoperative treatment of patients with chronic critical illness, with a focus on health prevention. Based on an analysis of the clinical data of patients with chronic critical illness, the study found that enteral nutrition nursing intervention plays a crucial role in enhancing the nutritional status of patients, reducing the incidence of complications, shortening the length of hospital stay, and improving the effect of postoperative rehabilitation. The study's results provide valuable insights into the efficacy of enteral nutrition nursing intervention in the postoperative treatment of patients with chronic critical illness. By improving the nutritional status of patients, enteral nutrition nursing intervention can help reduce the risk of complications, shorten the length of hospital stay, and enhance the effectiveness of postoperative rehabilitation. These findings underscore the importance of adopting effective interventions such as enteral nutrition nursing to improve the therapeutic outcomes of chronic critical illness patients and achieve the goal of health prevention.

Usefulness of post-operative endoscopic score for optimal treatment selection in recurrent eosinophilic chronic rhinosinusitis.

This study retrospectively analysed post-operative endoscopic scores to determine the optimal post-operative treatment in patients with eosinophilic chronic rhinosinusitis undergoing functional endoscopic sinus surgery. In total, 339 adults who underwent initial bilateral functional endoscopic sinus surgery for eosinophilic chronic rhinosinusitis were enrolled. Patients were divided into group A, which required no additional post-operative treatment; group B, which required local/systemic steroids post-operatively; and group C, which further required dupilumab and/or revision surgery. Sixty-five per cent of patients could be treated with initial functional endoscopic sinus surgery (group A). Post-operative steroids were required in 35 per cent of patients with a post-operative endoscopic score of 30 per cent (group B). Further advanced treatments with dupilumab and/or revision functional endoscopic sinus surgery were required in 10 per cent of patients with a post-operative endoscopic score of 65 per cent (group C). The post functional endoscopic sinus surgery endoscopic score can be used as an index to determine treatment at the time of eosinophilic chronic rhinosinusitis recurrence.

Early Detection of Molecular Residual Disease and Risk Stratification for Stage I to III Colorectal Cancer via Circulating Tumor DNA Methylation

Detection of molecular residual disease and risk stratification as early as possible may improve the treatment of patients with cancer. Efficient pragmatic tests are therefore required. To measure circulating tumor DNA (ctDNA) with 6 DNA methylation markers in blood samples and to evaluate the association of the presence of ctDNA with colorectal cancer (CRC) recurrence throughout the disease course. In this multicenter prospective longitudinal cohort study performed from December 12, 2019, to February 28, 2022, 350 patients with stage I to III CRC were recruited from 2 hospitals for collection of blood samples before and after surgery, during and after adjuvant chemotherapy, and every 3 months for up to 2 years. A multiplex, ctDNA methylation, quantitative polymerase chain reaction assay was used to detect ctDNA in plasma samples. A total of 299 patients with stage I to III CRC were evaluated. Of 296 patients with preoperative samples, 232 (78.4%) tested positive for any of the 6 ctDNA methylation markers. A total of 186 patients (62.2%) were male, and the mean (SD) age was 60.1 (10.3) years. At postoperative month 1, ctDNA-positive patients were 17.5 times more likely to relapse than were ctDNA-negative patients (hazard ratio [HR], 17.5; 95% CI, 8.9-34.4; P < .001). The integration of ctDNA and carcinoembryonic antigen tests showed risk stratification for recurrence with an HR of 19.0 (95% CI, 8.9-40.7; P < .001). Furthermore, ctDNA status at postoperative month 1 was strongly associated with prognosis in patients treated with adjuvant chemotherapy of different durations and intensities. After adjuvant chemotherapy, ctDNA-positive patients had a significantly shorter recurrence-free survival than did the ctDNA-negative patients (HR, 13.8; 95% CI, 5.9-32.1; P < .001). Longitudinal ctDNA analysis after the postdefinitive treatment showed a discriminating effect in that ctDNA-positive patients had poorer recurrence-free survival than did the ctDNA-negative patients (HR, 20.6; 95% CI, 9.5-44.9; P < .001). The discriminating effect was enhanced (HR, 68.8; 95% CI, 18.4-257.7; P < .001) when ctDNA status was maintained longitudinally. Postdefinitive treatment analysis detected CRC recurrence earlier than radiologically confirmed recurrence, with a median lead time of 3.3 months (IQR, 0.5-6.5 months). The findings of this cohort study suggest that longitudinal assessment of ctDNA methylation may enable the early detection of recurrence, potentially optimizing risk stratification and postoperative treatment of patients with CRC.

Oncoguía de cáncer de tiroides 2023

The incidence of thyroid cancer has been increasing in recent years, ranking it among the ten most frequent neoplasms. Fortunately, mortality is low, and patients have a good prognosis in most cases. More than 90 % of them are well - differentiated thyroid carcinoma. Advances in technology and access to imaging studies have made the diagnosis of thyroid nodules more frequent; thus, it is essential to know how to approach them to avoid overdiagnosis of thyroid cancer. There are different treatment options for patients with thyroid cancer, but a multidisciplinary team should always establish the best therapeutic approach. Surgery is the standard of treatment and the only therapeutic option with a curative objective. Radioactive iodine and radiotherapy are indicated in the postoperative treatment of patients with risk factors. As long as the disease is iodine - sensitive, radioactive iodine is the mainstay of therapy, always considering the possibility of surgery and/or salvage radiotherapy. The definition of iodine - refractory disease is continually being modified; however, when the multidisciplinary team believes that there is no longer any benefit from further application of radioactive iodine, it will be essential to identify the opportune moment to start systemic treatment with tyrosine kinase inhibitors. The choice of systemic treatment and its sequence must be individualized for each case, considering the clinicopathological characteristics of each case, the toxicity profile, and the patient's expectations.

Effect of postoperative radiotherapy on survival in patients with completely resected and pathologically confirmed stage N2 non-small-cell lung cancer: a systematic review and meta-analysis.

The role of postoperative radiotherapy (PORT) for patients with completely resected stage N2 non-small-cell lung cancer (NSCLC) has been controversial. This study aimed to investigate the efficacy of PORT and prognosis in these patients. An updated meta-analysis was conducted in this study to investigate the efficacy of PORT and prognosis in patients with completely resected and pathologically confirmed stage N2 NSCLC. This study is a systematic review and meta-analysis. Databases were searched up to 2 March 2022. All trials on patients with completely resected and pathologically confirmed stage N2 NSCLC undergoing PORT were screened, and data indicators in the PORT and non-PORT groups were extracted, respectively. The effect of PORT on overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) was estimated. Subgroup and sensitivity analyses were performed. In all, 20 studies involving 6340 patients were finally included. The PORT significantly increased OS [hazard ratio (HR) = 0.77, 95% CI: 0.71-0.84, p < 0.001), LRFS (HR = 0.63, 95% CI: 0.52-0.76, p < 0.001), and DFS (HR = 0.72, 95% CI: 0.63-0.82, p < 0.001) while it showed no significant difference in improving DMFS (HR = 0.86, 95% CI: 0.71-1.05, p = 0.14). Our results suggest that in the postoperative treatment of patients with completely resected and pathologically confirmed stage N2 NSCLC, the addition of PORT provides better local recurrence control and survival benefit, but no benefit for distant metastases. The PORT may be incorporated into the postoperative treatment options for some patients with high-risk factors. However, it needs to be validated by more prospective studies in the future. CRD42022314095.

Dosimetric Analysis of Online Adaptive Radiation Therapy in the Adjuvant Setting for Head and Neck Cancer

<h3>Purpose/Objective(s)</h3> Online adaptive radiotherapy (OnART) system designed to deliver re-optimized plans in real time using on-board cone beam CT and artificial intelligence has enabled frequent adaptation. Given the paucity of data on the role of adaptive radiotherapy (RT) and its frequency in the treatment of post-operative patients with head and neck squamous cell carcinoma (HNSCC), a dosimetric study was performed to assess the potential benefits of a single vs weekly OnART in this setting. <h3>Materials/Methods</h3> Twelve patients receiving conventionally fractionated RT (CFRT) over 6 weeks and 12 patients receiving hypofractionated RT (HFRT) over 3 weeks on a clinical trial between 2020 and 2021 were analyzed. The OnART plan was generated to meet the same quality as the original clinical plan and the OnART emulator was used to virtually conduct adaptive RT based on the patient's cone beam CT. The PTV coverage, dose heterogeneity, and cumulative dose to the organs-at-risk of a single mid-treatment OnART (at week 4 for CFRT and week 2 for HFRT) and weekly OnART were compared to the non-adapted plan. <h3>Results</h3> In total, 13, 8, and 3 patients had oral cavity, oropharynx, and larynx primaries, respectively, with 11 of the 24 patients receiving ipsilateral RT only. The average absolute and % weight loss during treatment were 5.7 lb and 3.1%, respectively. In the CFRT cohort, weekly OnART led to a significant improvement in high risk PTV (PTVHR) and standard risk PTV (PTVSR) V100 coverage (9.9% and 3.4% absolute) as well as hot spot (-1.3 Gy), max cord dose (-3.4 Gy), and mean oral cavity dose (-1.3 Gy), while the mean contralateral parotid dose increased modestly (0.76 Gy) (Table). When adapted once, only PTVHR coverage was improved (3.3%). For the HFRT cohort, weekly OnART resulted in a significant improvement in PTVHR/PTVSR coverage (3.7%/2.0%), hot spot (-0.82 Gy), and max cord dose (-2.5 Gy) (Table). When adapted once, mean oral cavity dose decreased (-1.4 Gy) and mean contralateral parotid dose increased (1.1 Gy). <h3>Conclusion</h3> There was a limited benefit of one-time OnART, but weekly adaptations improved the dosimetry, predominantly in PTV coverage and dose heterogeneity for patients receiving adjuvant RT for HNSCC. A prospective study is ongoing to determine the potential benefit in clinical and patient-reported outcomes of OnART in this setting.

A review of oculoplastic surgery and ocular surface disorders

Background: Ocular surface health is closely related to the condition of the ocular adnexa, particularly the eyelids. Both ocular adnexal disorders and oculoplastic procedures performed to treat them can cause ocular surface disorders (OSD). In this review, we aimed to summarize the relationship between oculoplastic procedures and OSD.&#x0D; Methods: In this narrative review, an electronic search of the PubMed/MEDLINE database was conducted using various combinations of keywords including “oculoplastic surgery,” “ocular surface disorders,” “dry eye,” and “management,” without time or language limitations, to include studies concerning oculoplastic surgery and OSD.&#x0D; Results: We included articles involving oculoplastic procedures and OSD with discussions of preventive approaches and management strategies in this context. For a systematic approach, the preoperative assessments and postoperative treatment of patients were retrieved and summarized. Preoperative preventive measures included evaluation of tear film break-up time, tear osmolarity, tear meniscus area and height measurement by anterior segment optic coherence tomography, lipid layer thickness by interferometer, corneal staining and Oxford Scheme, Schirmer test, blink rate and completeness, ocular surface disease index scoring, eyelid closure, and Bell’s phenomenon. Postoperative assessments included the presence and severity of dry eye and early management of dry eye with artificial tears, topical anti-inflammatory medications, and night taping; evaluation of the presence of chemosis, and, if present, management with pharmacologic, mechanical, or surgical therapies when needed; and prompt detection and treatment of lagophthalmos and consequent exposure keratopathy.&#x0D; Conclusions: Careful preoperative examination of the ocular surface is mandatory to reduce or eliminate complications after oculoplastic surgery. Ocular surface-related complications that surgeons encounter after oculoplastic surgery should be promptly diagnosed and treated.

Оценка применения лекарственного препарата «Цитофлавин»® у пациентов после эндовитреальной хирургии регматогенной отслойки сетчатки, осложненной пролиферативной витреоретинопатией

Purpose. To assess the functional efficiency of the obtained results of endovitreal surgery in patients with rhegmatogenous retinal detachment (RRD) by using Cytoflavin in the postoperative rehabilitation. Material and methods. 108 people (108 eyes) after surgery for RRD. Patients were divided into 2 groups: the 1st – 60 people who received Cytoflavin on the background of standard therapy, and the 2nd – 48 people with postoperative treatment only with standard therapy. We used Laser Doppler fluometry (LDF): microcirculation index and microcirculation efficiency index were recorded. Using OCT angiography (OCT-A) area nonperfusion of foveal avascular zone, density in the superficial capillary plexuses and density in the deep capillary plexuses in the macular area were investigated. Results. The inclusion of Cytoflavin in the postoperative rehabilitation of patients with RRD increases the possibility of a favorable functional outcome of the operation, affects the positive dynamics in the state of the capillary plexus in the macula. In the aggregate of patients of the 1st group, the increase in visual acuity was 2 times higher than in patients of the 2nd group 6 months after surgery. Conclusion. The prescription of Cytoflavin in the postoperative treatment of patients underwent endovitreal surgery of RRD increases the functional outcome of the operation. Keywords: rhegmatogenous retinal detachment, chorioretinal microcirculation, Laser Doppler fluometry, optical coherence tomography angiography, Cytoflavin.

Platelet-lymphocyte ratio predicts poor prognosis in stage II/III colon and rectum cancer

Objective: There is an increasing number of studies in the literature reporting that serum platelet/lymphocyte ratio (PLR) can provide useful prognostic data for various cancers. In the present study, the effects of platelet-lymphocyte ratio on survival in stage II/III colorectal cancers (CRC) were examined. Material and Method:A total of 106 Stage II/III CRC patients who underwent curative surgery 2015-2020 were included in the study. Emergency cases and patients diagnosed with other than adenocarcinoma were excluded from the study. The demographic data of the patients, preoperative imaging and laboratory results, postoperative pathology reports, and patient follow-up examination data were obtained from hospital records. The relations between demographic, histopathological, hematological values ​​and the prognosis was analyzed in terms of statistical significance. Results:Among the 106 patients, 62 (58.5%) were male and 44 (41.5%) were female. The mean age was 64.3±12.01 (23-89). The mean follow-up period was calculated as 24.6±15.8 (2-63) months. When the pathology reports were reviewed, it was found that the mean tumor diameter was 5.3±2.33 cm (2-17) and the mean metastatic lymph node was 1.8±2.4 (0-10). The PLR ratio was determined as a poor prognostic factor affecting survival in the cox regression analysis, in which preoperative complete blood count, c-reactive protein and albumin values, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and PLR were compared, and was separated from other variables (P=0.002 CI= 95%). When variables such as age, clinical stage, and tumor diameter were included in the model, PLR was similarly found to be an important predictive variable (P= 0.002). When only NLR, LMR, and PLR were evaluated, PLR again came to the forefront with a significance value of P=0.01. Also, high neutrophil count, increased platelet distribution volume (PDW), advanced age, and perineural invasion (PNI) were found to be significant factors in predicting poor prognosis. Conclusions: High PLR is a poor prognostic factor for CRC patients. For this reason, it may be necessary to follow a more aggressive strategy in the management of postoperative treatment in patients who have high PLR.