Stage Group Research Articles

Pediatric Medullary Thyroid Carcinoma: Clinical Presentations and Long-Term Outcomes in 144 Patients Over 6 Decades.

Sporadic medullary thyroid carcinoma (sMTC) rarely occurs in childhood and no studies have specifically focused on this entity. To describe the clinical presentations and long-term outcomes of a large cohort of children and young adults with sMTC compared with hereditary MTC (hMTC). Retrospective study of 144 patients diagnosed with MTC between 1961 and 2019 at an age ≤ 21 years and evaluated at a tertiary referral center. In contrast to hMTC (n = 124/144, 86%), patients with sMTC (n = 20/144, 14%) are older (P < .0001), have larger tumors (P < .0001), a higher initial stage grouping (P = .001) and have more structural disease (P = .0045) and distant metastases (DM) (P = .00084) at last follow-up, but are not more likely to die from MTC (P = .42). Among 77 patients diagnosed clinically, not by family history (20/20 sMTC and 57/124 hMTC), there was no difference in the initial stage (P = .27), presence of DM at diagnosis (P = 1.0), disease status at last follow-up (P = .13), overall survival (P = .57), or disease-specific survival (P = .87). Of the 12 sMTC tumors that underwent somatic testing, 11 (91%) had an identifiable alteration: 10 RET gene alterations and 1 ALK fusion. sMTC is primarily a RET-driven disease that represents 14% of childhood-onset MTC in this cohort. Pediatric sMTC patients are older, present with clinical disease at a more advanced TNM classification, and have more persistent disease at last follow-up compared with hMTC, but these differences disappear when comparing those presenting clinically. Somatic molecular testing should be considered in sMTC patients who would benefit from systemic therapy.

Utilization of Patient-Specific Characteristics and Competing Risks to Tailor the Duration of Surveillance Imaging After Surgery for Renal Cell Carcinoma

Purpose: The appropriate duration of follow-up after surgical resection of renal cell carcinoma (RCC) remains incompletely defined. To better inform on this time line, we investigate when an individual's risk of RCC recurrence becomes less significant than their risk of non-RCC death. Materials and Methods: We identified 1672 patients who underwent surgery for M0 RCC between 1999 and 2018. Patients were stratified by pathologic stage, histology, age, and Eastern Cooperative Oncology Group (ECOG) performance status. Cumulative incidence functions were estimated for RCC recurrence and non-RCC death using Fine and Gray models. Follow-up durations were estimated as the time point at which the cumulative incidence of non-RCC death exceeded that of RCC recurrence. Results: At a median follow-up of 2.1 years (IQR 0.6-5.1 years), a total of 272 recurrences (16.3%) and 234 non-RCC deaths (14.0%) occurred. The fitted model showed significant associations of stage with RCC recurrence and of age and ECOG with non-RCC death. For 50-year-old patients with pT1aN0-x clear cell and ECOG 0, the incidence of non-RCC death exceeded that of recurrence after 4.4 years. However, if such patients had an ECOG status of 1 or 2 to 4, the incidence of non-RCC death exceeded that of recurrence at 30 days, suggesting that routine oncologic surveillance may not be necessary. Alternatively, regardless of ECOG status, the incidence of non-RCC death failed to exceed that of recurrence for &gt;13.9 years in all patients age 50 with &gt; pT3aN0-x clear cell thereby suggesting longer surveillance than currently recommended. Conclusion: Modeling competing risks of RCC recurrence and non-RCC death provide patient-specific estimates when follow-up may be reasonably discontinued.

The genesis of the Baguamiao orogenic gold deposit linked to multistage ore-forming processes in Triassic tectonic transition of South Qinling, China

The Baguamiao gold deposit represents one of the largest Triassic orogenic gold deposits in the South Qinling metallogenic belt of central China. Here we investigate Ar-Ar dating of sericite and muscovite, fluid inclusion of quartz, the trace element and sulfur isotopic composition of pyrite from different mineralization stage in the Baguamiao gold deposit to gain insights into the ore genesis. The Ar-Ar dating results yield 40Ar/39Ar plateau ages of 217.5 ± 2.1 Ma, 209.2 ± 0.2 Ma and 208.8 ± 0.2 Ma, indicating a two-stage gold mineralization during the tectonic transition from the early metamorphic deformation (at ca. 218 Ma) to the late extension (ca. 209 Ma) in the post-collision environment. Fluid inclusion, trace element and sulfur isotopic analyses reveal that the two stages gold mineralization show different sources. The early mineralization period developed CO2-rich inclusions with medium temperature (317–413 °C) and medium–low salinity (4.62–18.81 wt% NaCleqv.), and is characterized by formation of Py1 and Py2 with depleted Au, Cu, Pb, Zn, Ag, Te and Bi. The sulfur isotope data of Py1 and Py2 are between 3.6 ∼ 10.5 ‰, suggesting that the sulfur source was mainly derived from the surrounding rock (Xinghongpu Group). The late mineralization period developed medium–high temperature (321–453 °C), medium–high salinity (3.3–19.62 wt% NaCleqv.) CO2-rich inclusions and high-temperature and high-salinity daughter crystal inclusions, and is characterized by formation of Py3 and Py4 with obviously higher arsenic and metal contents, such as Au, As, Cu, Pb, Zn, Ag, Cr, Ti, Mn, Sb. The δ34S values of Py3 and Py4 are 8.3 ∼ 18.8 ‰, suggesting a mixed fluid of the Xinghongpu Group and Gudaoling Group with deep magmatic-hydrothermal fluids. We propose that the two periods of gold mineralization in the Baguamiao deposit, in response to the collision assembly of Qinling Orogenic Belt, preserve evidence for diverse metal sources with the early mineralization period sourced from the metamorphism of the upper crust (Xinghongpu Group) in the compressional stage (ca. 218 Ma), and the late mineralization period characterized by the contribution of the Xinghongpu Group, Gudaoling Group and deep magmatic-hydrothermal fluids in a post-collisional extensional setting (ca. 209 Ma). The role of metamorphism and magmatic activity during the Triassic Qinling orogenic processes is considered to be important in the remobilization, transport and enrichment of sulfur, arsenic and gold (and potentially other trace elements) from the earlier formed seafloor exhalation sequence.

Effect of Feeding Level on Growth and Slaughter Performance, and Allometric Growth of Tissues and Organs in Female Growing Saanen Dairy Goats.

This study aimed to investigate the effect of feeding level on the growth and slaughter performance, and allometric growth of tissues and organs in female growing dairy goats. The trial included 10-20 and 20-30 kg weight stages with 48 female goat kids. The 24 goat kids in each stage were divided into 8 blocks based on weight, with 3 kids per block. Then, three kids from each block were randomly assigned to one of the three treatments, namely ad libitum (AL100), 70% of ad libitum (AL70), or 40% of ad libitum (AL40). The slaughter trial was conducted when the AL100 kids reached the target weight of 20 or 30 kg. The results showed that the ADG and feed conversion rate showed a linear decline as the feed level decreased (p < 0.05). Compared with the AL70 and AL100 groups, the AL40 group exhibited lower shrunk body weight, empty body weight, hot carcass weight, net meat rate, carcass meat rate, and visceral fat weight (p < 0.05) in both stages. Moreover, the AL40 group showed lower weights for skin and mohair, blood, rumen, small intestine, large intestine, mammary gland, and uterus than the AL70 and AL100 groups (p < 0.05) in both stages. However, feeding level did not affect organ indices in the two stages (p > 0.05). The bone, skin and mohair were isometric (b ≈ 1), but the muscle, visceral fat, and most internal organs were positive (b > 1) in both stages. In conclusion, feeding level affects the growth and development of dairy goats, which vary depending on the body weight stage and specific tissues and organs.

The Encyclopedia of Flora on Curiak Island to Improve Critical Thinking Skills of Science Education Students

This research aims to produce a flora encyclopedia product on Curiak Island that is suitable for improving critical thinking skills. Â Type of Educational Design Research (EDR) research using Tessmer formative evaluation design. The formative evaluation used consists of four stages, namely the self-evaluation stage, expert review, one-to-one evaluation, and small group evaluation. Collecting product validation data using an encyclopedia assessment instrument. Data regarding validity is collected through an encyclopedia validation sheet by giving a score of 1, 2, 3, or 4 (1 = not good, 2 = quite good, 3 = good, and 4 = very good). Critical thinking assessment use essay with four indicators. The findings show that the product developed is feasible in terms of material, media and language. The test results show that there is a significant difference in students' critical thinking abilities before and after learning. Apart from that, the analysis indicator in critical thinking skills obtained the highest score in the medium category. These findings illustrate that the effectiveness of product expectations is effective in improving students' critical thinking abilities.

Correlation and stage change of key groups and thermal effects of spontaneous coal combustion due to long-term ultraviolet illumination

This study aimed to unveil the correlation between the changes in active groups and thermal effects during the spontaneous coal combustion under prolonged ultraviolet (UV) irradiation. In situ Fourier transform–infrared spectroscopy (FTIR) and microcalorimetry (C80) experiments were conducted. Thermodynamic analysis, Pearson's correlation analysis, and Grey Relational Analysis (GRA) were employed to analyze the raw coal (R0) and the coal after UV irradiation for 3, 6, 9, and 12 months (R3, R6, R9, and R12). The results indicated that UV irradiation promotes the generation of Ar-CH, –CC-, CO, and –OH, while causing the consumption of –CH3. This promoting effect gradually increases within the first 6 months and then diminishes after 6 months. A thermodynamic analysis revealed a consistent trend in the apparent activation energy during Stages I and II, where R0<R12<R3<R9<R6. This result suggests that UV exposure promotes coal–oxygen reactions. In the correlation analysis, it was observed that the key active groups for R0 and UV-irradiated coal are not consistent across different stages, with –OH and –CO identified as the key active groups in Stages I and II of UV-irradiated coal, respectively. The correlation between –OH and –CO exhibits a distinct stage-wise variation with prolonged UV exposure.

Clinicopathologic features and survival outcomes of CD30 expression in extranodal natural killer/T-cell lymphoma.

Previous studies have been inconsistent concerning the association between the prognostic value of CD30 expression and extranodal natural killer/T-cell lymphoma (ENKTL). CD30 expression in 82 patients with newly diagnosed ENKTL (mean age, 50 years; 73.2% male) was assessed by immunohistochemistry on paraffin-embedded sections. The level of CD30 expression was categorized into negative (0%, no staining) and positive groups. Sixty-seven cases exhibited positive CD30 expression, and the main between-group difference was the Chinese Southwest Oncology Group and Asia Lymphoma Study Group (CA) ENKTL stage and Eastern Cooperative Oncology Group (ECOG) performance status. The cutoff point for CD30 expression was 40% by restricted cubic splines analysis. The overall survival of patients with high expression (>40%) was statistically superior to negative (0%) and low-expression groups. A positive correlation was observed between CD30 and Epstein-Barr virus-encoded small RNA status (r = 0.305). Multivariable analysis suggested that positive CD30 expression (hazard ratio, 0.420 [95% CI, 0.193-0.914]; P = .029) and CA advanced stage (hazard ratio, 2.844 [95% CI, 1.371-5.896]; P = .005) were independent prognostic factors for ENKTL. Positive CD30 expression was a favorable prognostic factor for ENKTL, and CD30 expression could restratify the survival of patients in clinical subgroups.

A Study of Ki-67 Immunostaining in Prostate Carcinomas and Its Correlation with Gleason's Score and Prognosis: An Experience at a Tertiary Centre in the Himalayan Foothills.

Prostate cancer is a significant cause of cancer-related mortality among men worldwide, necessitating the exploration of prognostic biomarkers to aid in accurate risk assessment and treatment decision-making. This cross-sectional study aimed to comprehensively evaluate the role of Ki-67 as a prognostic marker in prostate cancer by examining its association with clinicopathological parameters. A total of 102 archived cases of prostate core biopsy specimens, histopathologically reported as prostate carcinoma, were included in this study. Histopathological grading was conducted using Gleason's scoring and grading system based on morphology. The statistical software "R" was utilized for data analysis. Kruskal-Wallis test and Fisher's exact test were employed to analyze the association between Ki-67 expression and clinicopathological parameters. The study revealed significant correlations between Ki-67 expression and various clinicopathological parameters in prostate cancer cases. High Ki-67 expression levels were associated with higher Gleason scores, increased incidence of perineural invasion, advanced T stages, lymph node metastasis, presence of distant metastasis, and higher prognostic stage groups. The findings of this cross-sectional study support the potential of Ki-67 as a prognostic marker in prostate cancer. The significant associations observed between Ki-67 expression and clinicopathological parameters indicate its usefulness in risk stratification and treatment decision-making. The incorporation of histopathological grading, including Gleason scoring, and analysis of perineural invasion strengthens the validity of the study. Ki-67, in combination with morphological assessments, provides valuable prognostic information for prostate cancer patients.

Survival differences in non-seminoma testis cancer patients according to race/ethnicity

BackgroundHistoric evidence suggests that non-Caucasian race/ethnicity predisposes to higher testis cancer-specific mortality (CSM) in non-seminoma. However, it is unknown, whether higher CSM in non-Caucasians applies to Hispanics or Asians or African-Americans, or all of the above groups. In contemporary patients, we tested whether CSM is higher in these select non-Caucasian groups than in Caucasians, in overall and in stage-specific comparisons: stage I vs. stage II vs. stage III. MethodsThe Surveillance, Epidemiology, and End Results (SEER) database (2004 −2019) was used. Kaplan-Meier plots and multivariable Cox regression models tested the effect of race/ethnicity on CSM after stratification for stage (I vs. II vs. III) and adjustment for prognosis groups in stage III. ResultsIn all 13,515 non-seminoma patients, CSM in non-Caucasians was invariably higher than in Caucasians. In stage-specific analyses, race/ethnicity represented an independent predictor of CSM in Hispanics in stage I (HR 1.8, p = 0.004), stage II (HR 2.2, p = 0.007) and stage III (HR 1.4, p < 0.001); in African-Americans in stage I (HR 3.2; p = 0.007) and stage III (HR 1.5; p = 0.042); and in Asians in only stage III (HR 1.6, p = 0.01). ConclusionsIn general, CSM is higher in non-Caucasian non-seminoma patients. However, the CSM increase differs according to non-Caucasian race/ethnicity groups. Specifically, higher CSM applies to all stages of non-seminoma in Hispanics, to stages I and III in African-Americans and only to stage III in Asians. These differences are important for individual patient management, as well as for design of prospective trials.

MRI Plain Scan: A Tool in the Management of Cervical Cancer during Pregnancy.

The purpose of this study was to assess the diagnostic value of magnetic resonance imaging (MRI) in staging and treatment of cervical cancer in pregnancy, and to evaluate the benefit of apparent diffusion coefficient (ADC) during neoadjuvant chemotherapy management. This was a retrospective cohort study. Patients were divided into two groups according to the stage of cervical cancer. The mean term of pregnancy at the time of the diagnosis was the early second trimester (range 10-27 weeks) and the median age was 33 years (range 26-40 years). The abdominal and pelvic MRI images and clinical data of these patients were reviewed. Tumor size, local tumor spread, and nodal involvement were evaluated using an MRI dataset. The treatment and follow-up imaging were analyzed as well, and the ADC was measured before and after the chemotherapy. 16 patients with histopathologically confirmed cervical cancer during pregnancy were retrospectively enrolled. 7 patients were diagnosed with local cervical cancer (FIGO stage IAI) and designated as early stage group, as the lesion was invisible on MRI. In this group, pregnancies were allowed to continue until cesarean delivery (CD) at 38-41 weeks. The other 9 patients presenting with local or extensive cervical cancer (FIGO stage IB2-IIA2) were designated as the advanced-stage group. The lesion could be measured and analyzed on MRI. They were treated with neoadjuvant chemotherapy in pregnancy. Among them, 6 patients underwent TP regimen (paclitaxel 135~175 mg/m2 plus cisplatin 70~75 mg/m2), while 3 patients received TC regimen (paclitaxel 135~175 mg/m2 plus carboplatin AUC=5). NACT was performed for 1 to 2 courses before surgery. ADC demonstrated significant differences before and after chemotherapy administered during pregnancy (1.06 ± 0.12 sec/mm2 vs. 1.34 ± 0.21 sec/mm2). MRI has been found to be helpful in staging cervical cancer in pregnancy. Patients with stage IA confirmed by MRI can choose conservative treatment and continue the pregnancy until term birth. MRI can dynamically monitor the efficacy of chemotherapy for patients with stage IB and above during pregnancy. ADC value can have a potential role in the evaluation of chemotherapy efficacy.

Bacillus velezensis promotes the proliferation of lactic acid bacteria and influences the fermentation quality of whole-plant corn silage.

This study aimed to investigate the promoting effect of a Bacillus velezensis (BV) strain on lactic acid bacteria (LAB) and determine its influence on the fermentation quality and aerobic stability of silage. Flat colony counting method was used to evaluate the effect of BV on the growth of LAB. Freshly harvested whole-plant corn was inoculated separately with BV and L. plantarum (LP), along with an uninoculated control group (CK), and assessed at 1, 3, 5, 7, 15, and 30 days of ensiling. The results indicated that BV exhibited a proliferative effect on Weissella confusa, Lactobacillus plantarum L-2, and Pediococcus pentosaceus. And exhibited a more rapid pH reduction in BV-inoculated silage compared with that in CK and LP-inoculated silage during the initial stage of ensiling. Throughout ensiling, the BV and LP experimental groups showed enhanced silage fermentation quality over CK. Additionally, relative to LP-inoculated silage, BV-inoculated silage displayed reduced pH and propionic acid. BV also prolonged aerobic stability under aerobic conditions. The microbial community in BV-inoculated silage showed greater stability than that in LP-inoculated silage. Additionally, Firmicutes and Lactobacillus exhibited more rapid elevation initially in BV versus LP-inoculated silage, but reached comparable levels between the two inoculation groups in the later stage. In summary, BV enhanced the efficacy and aerobic stability of whole-plant corn silage fermentation by stimulating LAB proliferation.

Combination Assay of Methylated HOXA1 with Tumor Markers Shows High Sensitivity for Detection of Early-Stage Hepatocellular Carcinoma

Introduction: Patients with hepatitis virus-related hepatocellular carcinoma (viral HCC) are decreasing as hepatitis control improves, but those with non-viral-related HCC (non-viral HCC) are increasing in Japan. No established surveillance system exists for patients with non-viral HCC, so they are often diagnosed at an advanced stage. To address this, we performed this study. Methods: We collected serum samples from 516 participants (154 healthy subjects, 93 chronic liver disease [CLD] patients without HCC, and 269 HCC patients). Participants were divided into a control group comprising healthy subjects and patients with CLD and an HCC group. We evaluated serum methylated HOXA1 (m-HOXA1) copy numbers using modified combined restriction digital PCR (CORD) assay (1-step CORD assay). We assessed diagnostic performance of m-HOXA1 compared to HCC tumor markers alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) and created a novel index to improve HCC prediction. Results: Serum m-HOXA1 level was significantly higher in each HCC stage group versus the control group. Its sensitivity was 69.1% and specificity was 78.5% for diagnosing HCC. The area under the curve (AUC) of m-HOXA1 was superior to that of AFP and equal to that of DCP. Multivariate logistic regression analysis revealed independent contributions of m-HOXA1, DCP, and AFP, in that order of strength, to diagnose HCC after adjustment for age and sex. We designated the predictive probability of HCC based on the regression model as the ASDAm-H1 (Age, Sex, DCP, AFP, and m-HOXA1) index. Its diagnostic accuracy was 0.96 by AUC with a sensitivity of 86.2% and specificity of 93.9%. Sensitivity was identical for viral and non-viral HCCs. When limited to early-stage HCC, sensitivity of the ASDAm-H1 index was 76.3%. Conclusions: We showed distinguished performance of the ASDAm-H1 index to detect viral and non-viral HCC, even at an early stage. This index might have potential as a non-viral HCC surveillance system.

Housework participation and mortality in Japanese male patients undergoing cancer surgery: A propensity score-matched study

BackgroundParticipation in housework and meal preparation are instrumental activity of daily living (IADL) evaluation items that is known to predict prognosis and complications in cancer care. However, these items are often assessed only for females, not for males, in IADL. MethodsWe examined the impact of habit of housework and meal preparation on overall survival (OS) in 1025 Japanese male patients who underwent elective urologic cancer surgery at our institution. The study also used a cohort that was matched by propensity score. ResultsWe found that patients who did not prepare meals or do housework had significantly shorter OS (hazard ratio [HR] = 3.34, P = 0.005; HR = 5.01, P < 0.001, respectively). Even in the cohort of 448 patients matched by propensity score and adjusted for age, body mass index, comorbidities, performance status, living status, cancer type, stage groups of cancer, and surgical approach, lack of participation in housework was associated with shorter OS (HR = 2.92, P = 0.04) and was an independent predictor of worse OS in multivariable analysis (HR = 5.13, P = 0.008). ConclusionsMales who did not regularly do household chores before elective cancer surgery had worse life outcomes. Doing more daily physical activities, such as household chores like making the bed and cleaning the room, might have a positive impact on survival when fighting cancer.

The impact of prolonged face mask use on ocular surface health during COVID-19 pandemic: a clinical, and conjunctiva impression cytology study.

To investigate the relationship between prolonged face mask use and ocular surface health utilizing conjunctival impression cytology, the Schirmer test, the tear break-up time (TBUT) test, and the ocular surface disease index (OSDI) questionnaire. In this cross-sectional prospective study, individuals who used face masksfor at least eight hours per day for at least six months were compared to healthy volunteers who used face masks for no more than one hour per day. Each participant completed an OSDI questionnaire. The Schirmer test (under anesthesia), the TBUT test, and conjunctiva impression cytology analysis according to the Nelson classification method were performed on each participant. This study included 102 (49 male, 53 female) face mask users with an average age of 33.29 ± 7.71years and 110 (60 male, 50 female) healthy controls with an average age of 32.96 ± 7.10years (p = 0.746). The total OSDI score was significantly higher in face mask users than the control group (25.18 ± 3.54 vs 9.46 ± 2.13, p < 0.001). The mean Schirmer test value and TBUT were significantly lower in the study group than the control group (p < 0.001, p < 0.001). There was a statistically significant difference between the two groups in total score and stage of the Nelson classification system (p < 0.001, and p = 0.024, respectively). All conjunctiva impression cytology assessments, including cellularity, cell-cell contact, nucleus/cytoplasma ratio, goblet cell amount, and metaplasia, revealed statistically significant deterioration in the study group compared to the control group (p < 0.001, p = 0.025, p < 0.001, p < 0.001, and p < 0.001, respectively). The prolonged useof face masks leads to dry eyes. The findings of conjunctiva impression cytology indicate the role of inflammation in the pathogenesis of mask associateddry eye.

Enucleation and Dermato-fat Graft for Retinoblastoma Management : A Case Report

Introduction : Retinoblastoma is the most common intraocular malignant tumor found in children before 3 years old can occur unilaterally, bilaterally, hereditary or sporadic. Incidence of about 1:14,000-20,000 individuals. This tumor originated from embryogenic retinal cells. Retinoblastoma gene (RB1) located in the 13q14 chromosome&#x0D; Case Illustration : A 3-year-old girl presented with leukocoria. Her parents notice whitish in her right eye swollen, teary, painful since 2 months ago. No family history. Visual acuity (VA) on the oculus dextra ( OD) no light perception, oculus sinistra (OS) 6/6. Intraocular pressure on OD n-1/palpation, OS n/palpation. Examination under anasthesia for diagnostic found there weren’t palpebral edema, conjunctival injection, hazy cornea, pupil, lens couldn’t be evaluated on OD. Ultrasound showed sugest vitreous seeding and ptisis. CT scan showed solid mass with calcification and diagnosed retinoblastoma stage group E. Patient was treated with chemoreduction using Vincristine, Etoposide, Carboplatine combined enucleation with dermato-fat graft. We did nervus opticus dissection and histopathological examination which showed retinoblastoma.&#x0D; Discussion : The common signs of retinoblastoma is leukocoria. The priority is saving life followed by globe preservation. Treatment based on the stage of the disease. We did chemotherapy in this patient, followed by enucleation and dermato-fat graft. Enucleation stills the main therapy for saving life with nervus opticus dissection as possible. Dermato-fat graft has been shown to grow along with the expanding orbit in children therefore shows cosmetics.&#x0D; Conclusion : This report illustrates a case of Retinoblastoma. The chemotherapy and enucleation using safe dermato-fat graft procedure with implant followed by a well fitted prosthesis for better cosmetics

Is Robotic Surgery Beneficial for Rectal Cancer Patients with Unfavorable Characteristic After Neoadjuvant Chemoradiotherapy?

The objective of this study was to compare long-term oncologic outcomes of robot and laparoscopic surgeries for patients with advanced rectal cancer who underwent neoadjuvant chemoradiotherapy (nCRT) followed by radical resection. This study analyzed 3240 rectal cancer patients who underwent radical surgery from 2008 to 2019. Among them, 1204 patients who received nCRT (robotic, n = 316; laparoscopic, n = 888) were analyzed. The oncological outcome according to the number of unfavorable factors (male, body mass index ≥ 25, receiving CCRT) present in patients also was analyzed. We used 1:1 propensity score matching (PSM) to adjust for potential baseline confounders between groups. After PSM, two groups showed similar demographics and pathological results. After PSM analysis, the robotic group showed higher 5-year disease-free survival (DFS) and local recurrence-free survival rates than the laparoscopic group, whereas 5-year overall survival and distant recurrence-free survival rates were similar between the two groups. In addition, by comparing survival rates for each yp stage, it was found 5-year DFS and local recurrence-free survival of the robotic group in yp stage III were significantly higher than those of the laparoscopic group. Five-year DFS was conducted according to the number of unfavorable factors (male, body mass index ≥ 25 kg/m2, and undergoing nCRT) as a subgroup analysis. In patients with all three unfavorable factors, the robotic group showed significantly higher DFS than the laparoscopic group. Robotic approach for rectal cancer after nCRT, especially for patients with yp stage III and unfavorable factors, have the advantage of improving oncologic outcomes even for surgeons specializing in colorectal cancer.

Porous Zinc Oxide and Plant Polyphenols as a Replacement for High-Dose Zinc Oxide on Growth Performance, Diarrhea Incidence, Intestinal Morphology and Microbial Diversity of Weaned Piglets

The aim of this experiment is to evaluate the effects of adding porous zinc oxide, plant polyphenols, and their combination to diets without antibiotics and high-dose zinc oxide on the growth performance, diarrhea incidence, intestinal morphology, and microbial diversity of weaned piglets. A total of 150 Duroc × Landrace × Large White weaned piglets were allocated to one of five diets in a randomized complete block design with six replicates and five piglets per replicate. The experimental period was 42 d, divided into two feeding stages: pre-starter (0–14 d) and starter (14–42 d). In the pre-starter stage, the negative control group (NC) was fed a basal diet, the positive control group (PC) was fed a basal diet with 2000 mg/kg of zinc oxide, the porous zinc oxide group (PZ) was fed a basal diet with 500 mg/kg of porous zinc oxide, the plant polyphenol group (PP) was fed a basal diet with 1500 mg/kg of plant polyphenols, and the combination group (PZ + PP) was fed a basal diet with 500 mg/kg of porous zinc oxide and 1500 mg/kg of plant polyphenols. In the starter stage, the NC, PC, and PZ groups were fed a basal diet, while the PP and PZ + PP groups were fed a basal diet with 1000 mg/kg of plant polyphenols. The results showed that, (1) compared with the PZ group, adding plant polyphenols to the diet showed a trend of increasing the ADFI of weaned piglets from 14 to 28 d (p = 0.099). From days 28 to 42 and days 0 to 42, porous zinc oxide and the combination of porous zinc oxide and plant polyphenols added to the control diet improved the FCR to the level observed in pigs fed the PC diet. (2) Dietary PZ + PP tended to increase the jejunal villus height (VH) of weaned piglets (p = 0.055), and significantly increased the villus-height-to-crypt-depth ratio compared to the NC group (p &lt; 0.05). (3) Compared with the NC group, PZ supplementation decreased the relative abundance of Firmicutes and increased the relative abundance of Bacteroidetes, and the relative abundance of Lactobacillus in the PZ and PZ + PP groups were both increased. In conclusion, porous zinc oxide and plant polyphenols may have synergistic effects in modulating intestinal health in weaned piglets and be a potential alternative to high-dose zinc oxide.

(085) Long-Term Outcomes of Testosterone Replacement Therapy Delaying Biochemical Recurrence Post-RARP: Frequency-Matched Case-Control Study

Abstract Introduction Testosterone Replacement Therapy (TRT) is known to improve functional and sexual outcomes in hypogonadal men. TRT historically has been contraindicated for the management of hypogonadism in men with prostate cancer (PC). Objective In 2020, we demonstrated in a cohort of 850 men that TRT reduced biochemical recurrence (BCR) by 50% (median follow-up 3.5 yrs.). The present study extends the follow up to 5.25 years Methods A retrospective review of prospectively collected data between December 2009 and June 2018 undergoing robotic radical prostatectomy by a single surgeon was conducted. 152 patients were administered TRT post-RP with a calculated free testosterone (cFT; below the 25%) and were frequency matched to 420 patients not receiving TRT with respect to pathological stage (p-stage) and Gleason Grade Group (GGG). Biochemical recurrence (BCR) was defined as two consecutive prostate specific antigen (PSA) blood tests &amp;gt;0.2 ng/mL. An adjusted Kaplan-Meier (KM) graph was used to analyze rate and time to BCR. Results Baseline differences in demographics were observed in BMI (p = 0.006) and follow up time (p = 0.0023), and cFT (p = 0.0156). While overall BCR was not significantly different between the two groups, a difference was observed in time to recurrence. In adjusted KM analysis, patients with a higher calculated free testosterone were less likely to have a BCR (p = 0.05). In the same analysis, patients with a higher GGG, p-stage, and preoperative PSA (p &amp;lt;0.01) were more likely to have a BCR. Patients receiving TRT had similar rates of BCR (p = 0.676). However, if they recurred, there was an average delay of 1.4 years. Conclusions TRT was observed to have a continuing protective effect in preventing and delaying BCR in patients post-RARP when compared to patients who did not receive TRT. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla.

Incidence, therapy, and prognosis of prostate cancer in Baden-Württemberg: analysis based on cancer registry data

Prostate cancer (PCa) is the most common solid tumor in men in Germany. Collection of epidemiological and clinical data has been centralized for several years due to legal requirements via the state cancer registries. Thus, the reporting of diagnosis, therapy, and progression of cancer is obligatory in Germany. These data needs to be processed based on the questions of the treating physicians. Intention of this work was to present the development of new cases, disease stages, treatment procedures and prognosis of PCa in Baden-Württemberg (BW). For this purpose, data of the cancer registry BW regarding patients with PCa first diagnosed between 2013 and 2021 were evaluated. The evaluation was performed using descriptive statistics, Χ2 test and Kaplan-Meier analysis. A total of 84,347 new diagnoses of PCa were reported. Clinical stage was present in 55.3% of patients. Assignment by International Society of Urological Pathology (ISUP) groups was present in 75.7%. Asteady increase in primary diagnosis was evident through 2019. The proportion of primary metastatic disease decreased (2013: 19.6% vs. 2021: 12.0%), and the proportion of localized tumors increased (2013: 65.5% vs. 2021: 77.1%). Radical prostatectomy (RP) dominated the treatment of localized tumors with amean of 60.1%. The proportion of robot-assisted surgery increased from 23.7% (2013) to 60.8% (2021) with adecrease in the R1 rate from 34.8 to 26.2%. Progression-free survival correlated closely with tumor stage and ISUP group. An increase in PCa cases and adecrease of advanced tumors were observed. Treatment was mostly surgical in localized stages, with increasing proportion of robotic-assisted RP. Early diagnosis and treatment are critical for long-term prognosis.

METHODOLOGICAL ASPECTS OF ASSESSING THE GENDER IMPACT IMPLEMENTATION OF THE TERRITORIAL COMMUNITY DEVELOPMENT STRATEGY

Purpose. The purpose of the article is to substantiate the main aspects that form a methodological approach to assessing the gender impact of the action and implementation of the Territorial Community Development Strategy. Design/methodology/approach. Semantic analysis, comparative analysis and the systematisation method were used to form a system of gender-sensitive indicators; the grouping method and structural and logical modelling were used to develop a rationale for the sequence of gender impact assessment. The abstract and logical method was used to formulate conclusions and theoretically summarise the results of the study. Findings. The main task of conducting a gender impact assessment of a community development strategy is to determine whether certain programmes or development processes have contributed to or hindered the implementation of gender equality principles in the community. Based on the analysis of scientific and methodological sources, the article presents the gender impact assessment as a set of mutually agreed stages. At the first stage, the goals, principles and target groups of gender-sensitive groups are established. A gender analysis is conducted to identify existing gender roles and the challenges and obstacles to equal participation that they pose for gender-sensitive groups. The development of a gender-responsive methodology includes the creation of a system of methods, rules, principles and approaches aimed at assessing gender equality and determining the impact of a particular community development strategy on gender aspects. In order to assess gender impact, the article develops a system of gender-sensitive indicators. Presentation of the results, conclusions and recommendations in the gender impact assessment of the action or implementation of the community development strategy is the final stage. At this stage, a detailedpresentation of the information obtained is made, and the main conclusions are formulated regarding the identified gender inequalities and the specifics of the impact of the programme document on gender-sensitive groups. The results of the assessment and recommendations can be made public to the public and other stakeholders, and public discussions and hearings can be organised, as well as consultations with residents of the local community to ensure broad participation and involvement of different groups. The developed conclusions and recommendations are usually documented in the form of a report. The proposed methodological approach to gender impact assessment was tested on the data and information contained in the Development Strategy of Velyky Bychkivska settlement territorial community for the period up to 2027. The Velyky Bychkiv territorial community is located in the Rakhiv district of the Zakarpattia region of Ukraine. Practical implications. The practical implications encompass the development of a more effective methodological approach for assessing gender impact within the context of territorial community development strategies. This contribution holds significance for local self-government bodies, governmental entities, activist groups, and other stakeholders involved in the process. Implementing the proposed methodological approach has the potential to enhance the overall management of territorial development, ensuring a more efficient consideration of gender aspects in decision-making processes. Moreover, it can contribute to heightened gender sensitivity among participants involved in the decision-making process, fostering a more inclusive and equitable approach to strategic community development. Originality/value. The originality and value of the article lie in its innovative methodological approach to evaluating the gender impact of implementing the Territorial Community Development Strategy. The article introduces a comprehensive framework that not only identifies and analyzes gender-specific factors at various stages but also offers practical recommendations for addressing gender inequalities within the context of community development. This contribution adds unique insights to the existing literature by providing a nuanced and context-specific methodology tailored to the intricacies of territorial community development. The article's value extends to practitioners, policymakers, and researchers engaged in gender-responsive planning, offering a practical tool to enhance the effectiveness and inclusivity of strategic development initiatives