[Surgical teratment for gastric cancer patients with liver metastasis]

Influence of cancer-directed surgery on the prognosis of liver metastases from gastric cancer

There are controversial about the application of cancer-directed surgery (CDS) in patients with liver metastases from gastric cancer, with improved responses to chemotherapy and targeted treatments, the role of CDS in metastatic gastric cancer to the liver needs to be revisited. This study aimed to evaluate the effect of CDS on patients with liver metastases from gastric cancer. Data for patients with liver metastases from gastric cancer were extracted from the population-based Surveillance, Epidemiology, and End Results (SEER) database. A total of 958 individuals were enrolled, 285 in the CDS group and 673 in the non-cancer guided surgery (Non-CDS) group. Following propensity score matching (PSM) analysis at 1:1 in the two groups,285 were included in the survival analysis for each group. Kaplan-Meier values and Cox proportional risk models were used to estimate the effect of CDS on patients' prognoses. Compared with the Non-CDS group, the CDS group significantly prolonged the median overall survival from 4 months (95% confidence interval [CI] 3-5) to 11 months (95% CI 8-12), p value < 0.001. Overall survival (OS) at 1 year was higher in the CDS group than in the Non-CDS group, at 44% (95 CI 38-50) and 25% (95 CI 20-30), respectively. OS at 3 years was also higher in the CDS group than in the Non-CDS group, at 24% (95 CI 19-29) and 6% (95 CI 3-9), respectively. Multivariate analysis showed that Non-CDS (hazard ratio[HR] = 2.26, 95% CI 1.88-2.72, p value < 0.001) was an adverse independent prognostic factor for patients. This study concludes that CDS prolonged survival in patients with gastric cancer with liver metastases. Due to the lack of information on the quality of life, biomarkers, targeted therapies, and immunotherapy in the SEER database, the observed improved survival rates following CDS of hepatic metastasis from gastric cancer requires prospective studies that take these factors into account to properly address the survival advantages and impact on quality of life of such a method.

Machine learning algorithm of ultrasound-mediated intestinal function recovery and nursing efficacy analysis of lower gastrointestinal malignant tumor after surgery

Objectives:

In this paper, machine learning algorithms was used to explore the application value of ultrasound contrast in the early evaluation of neoadjuvant chemotherapy in patients with gastrointestinal malignant liver metastases, and analyzes the effect of sports nursing methods on intestinal function recovery.

Methods:

Forty-seven patients with gastrointestinal malignancies were divided into 25 patients (combined chemotherapy group) and 22 cases (chemotherapy group) from April 2018 to April 2019. Two groups of patients were treated with CEUS. The effective lesion patients and invalid quantitative parameters were compared between the two groups before and after treatment, and the postoperative routine nursing was implemented.

Results:

Chemotherapy group effective in 18 cases, accounting for 81.82%; 4 cases, 18.18%. Combination chemotherapy patients 21 cases, accounting for 84.00%; 4 cases, accounting for 16.00%.

Conclusion:

Based on early is important to assess the efficacy of neoadjuvant chemotherapy in patients with liver metastases peak intensity ultrasound contrast parameters of the machine learning algorithms malignant tumors in the gastrointestinal tract, post-operative care movement helps to restore bowel function.