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Wang SH, Yeh CH, Wu CW, Hsu CY, Tsai EM, Hung CM, Wang YW, Hsieh TH. PFDN4 as a Prognostic Marker Was Associated with Chemotherapy Resistance through CREBP1/AURKA Pathway in Triple-Negative Breast Cancer. Int J Mol Sci 2024; 25:3906. [PMID: 38612711 PMCID: PMC11012048 DOI: 10.3390/ijms25073906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/12/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Breast cancer is the most common malignancy and its incidence is increasing. It is currently mainly treated by clinical chemotherapy, but chemoresistance remains poorly understood. Prefolded proteins 4 (PFDN4) are molecular chaperone complexes that bind to newly synthesized polypeptides and allow them to fold correctly to stabilize protein formation. This study aimed to investigate the role of PFDN4 in chemotherapy resistance in breast cancer. Our study found that PFDN4 was highly expressed in breast cancer compared to normal tissues and was statistically significantly associated with stage, nodal status, subclasses (luminal, HER2 positive and triple negative), triple-negative subtype and disease-specific survival by TCGA database analysis. CRISPR knockout of PFDN4 inhibited the growth of 89% of breast cancer cell lines, and the triple-negative cell line exhibited a stronger inhibitory effect than the non-triple-negative cell line. High PFDN4 expression was associated with poor overall survival in chemotherapy and resistance to doxorubicin and paclitaxel through the CREBP1/AURKA pathway in the triple-negative MDAMB231 cell line. This study provides insightful evidence for the value of PFDN4 in poor prognosis and chemotherapy resistance in breast cancer patients.
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Affiliation(s)
- Shih-Ho Wang
- Division of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Cheng-Hsi Yeh
- Division of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Chia-Wei Wu
- Department of Medical Research, E-Da Hospital/E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (C.-W.W.); (Y.-W.W.)
| | - Chia-Yi Hsu
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; (C.-Y.H.)
| | - Eing-Mei Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; (C.-Y.H.)
| | - Chao-Ming Hung
- Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Yi-Wen Wang
- Department of Medical Research, E-Da Hospital/E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (C.-W.W.); (Y.-W.W.)
| | - Tsung-Hua Hsieh
- Department of Medical Research, E-Da Hospital/E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (C.-W.W.); (Y.-W.W.)
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Tseng PT, Zeng BY, Chen JJ, Kuo CH, Zeng BS, Kuo JS, Cheng YS, Sun CK, Wu YC, Tu YK, Stubbs B, Carvalho AF, Liang CS, Chen TY, Hsu CW, Suen MW, Yang CP, Hsu SP, Chen YW, Shiue YL, Hung CM, Su KP, Lin PY. High Dosage Omega-3 Fatty Acids Outperform Existing Pharmacological Options for Migraine Prophylaxis: A Network Meta-Analysis. Adv Nutr 2024; 15:100163. [PMID: 38110000 PMCID: PMC10808921 DOI: 10.1016/j.advnut.2023.100163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/08/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023] Open
Abstract
Migraine is a highly prevalent neurologic disorder with prevalence rates ranging from 9% to 18% worldwide. Current pharmacologic prophylactic strategies for migraine have limited efficacy and acceptability, with relatively low response rates of 40% to 50% and limited safety profiles. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are considered promising therapeutic agents for migraine prophylaxis. The aim of this network meta-analysis (NMA) was to compare the efficacy and acceptability of various dosages of EPA/DHA and other current Food and Drug Administration-approved or guideline-recommended prophylactic pharmacologic interventions for migraine. Randomized controlled trials (RCTs) were eligible for inclusion if they enrolled participants with a diagnosis of either episodic or chronic migraine. All NMA procedures were conducted under the frequentist model. The primary outcomes assessed were 1) changes in migraine frequency and 2) acceptability (i.e., dropout for any reason). Secondary outcomes included response rates, changes in migraine severity, changes in the frequency of using rescue medications, and frequency of any adverse events. Forty RCTs were included (N = 6616; mean age = 35.0 y; 78.9% women). Our analysis showed that supplementation with high dosage EPA/DHA yields the highest decrease in migraine frequency [standardized mean difference (SMD): -1.36; 95% confidence interval (CI): -2.32, -0.39 compared with placebo] and the largest decrease in migraine severity (SMD: -2.23; 95% CI: -3.17, -1.30 compared with placebo) in all studied interventions. Furthermore, supplementation with high dosage EPA/DHA showed the most favorable acceptability rates (odds ratio: 1.00; 95% CI: 0.06, 17.41 compared with placebo) of all examined prophylactic treatments. This study provides compelling evidence that high dosage EPA/DHA supplementation can be considered a first-choice treatment of migraine prophylaxis because this treatment displayed the highest efficacy and highest acceptability of all studied treatments. This study was registered in PROSPERO as CRD42022319577.
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Affiliation(s)
- Ping-Tao Tseng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Psychology, Collage of Medical and Health Science, Taichung, Asia University, Taiwan; Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan; Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
| | - Bing-Yan Zeng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Jiann-Jy Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan; Department of Otorhinolaryngology, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chun-Hsien Kuo
- Department of Psychology, Collage of Medical and Health Science, Taichung, Asia University, Taiwan
| | - Bing-Syuan Zeng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - John S Kuo
- Neuroscience and Brain Disease Center and Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Yu-Shian Cheng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, College of Medicine, I-Shou University Kaohsiung, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Positive Ageing Research Institute (PARI), Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Andre F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Mein-Woei Suen
- Department of Psychology, Collage of Medical and Health Science, Taichung, Asia University, Taiwan; Gender Equality Education and Research Center, Asia University, Taichung, Taiwan; Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan; Department of Nutrition, Hungkuang University, Taichung, Taiwan
| | - Shih-Pin Hsu
- Department of Neurology, E-Da hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan
| | - Yow-Ling Shiue
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan.
| | - Chao-Ming Hung
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan; Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.
| | - Kuan-Pin Su
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan; An-Nan Hospital, China Medical University, Tainan, Taiwan.
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital.
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Chiu SUF, Hung CM, Chiu CC. A commentary on 'Approved and investigational fluorescent optical imaging agents for disease detection in surgery'. Int J Surg 2024; 110:611-612. [PMID: 37800572 PMCID: PMC10793771 DOI: 10.1097/js9.0000000000000799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 10/07/2023]
Affiliation(s)
- Si-Un Frank Chiu
- Department of Computer Science
- Department of Economics, Brown University, Providence, Rhode Island, USA
| | - Chao-Ming Hung
- Department of General Surgery
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery
- Department of Medical Education and Research, E-Da Cancer Hospital
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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Hung CM, Zeng BY, Zeng BS, Sun CK, Cheng YS, Su KP, Wu YC, Chen TY, Lin PY, Liang CS, Hsu CW, Chu CS, Chen YW, Yeh PY, Wu MK, Tseng PT, Matsuoka YJ. Cancer related fatigue-light therapy: updated meta-analysis of randomised controlled trials. BMJ Support Palliat Care 2023; 13:e437-e445. [PMID: 34266911 DOI: 10.1136/bmjspcare-2021-003135] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/28/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Moderate-to-severe cancer related fatigue occurs in 45% of patients with cancer and interferes with many aspects of quality of life. Although physical exercise has level 1 evidence for improvement of cancer related fatigue, it has a relatively high behavioural demand compared with other non-pharmacological interventions. The aim of this updated meta-analysis was to address the efficacy of light therapy in improving cancer related fatigue in patients with cancer. METHODS We included randomised controlled trials investigating the efficacy of bright white light (BWL) therapy in ameliorating cancer related fatigue in patients with cancer. This meta-analysis was conducted using a random-effects model. The target outcomes were changes in cancer related fatigue associated with BWL or dim red light (DRL). RESULTS There were 9 articles with 231 participants included. The main results revealed that daily morning BWL for 30 min was associated with significantly better improvement in fatigue severity compared with DRL (k=5, Hedges' g=-0.414, 95% CI -0.740 to -0.087, p=0.013). The subgroup without psychiatric comorbidities (k=4, Hedges' g=-0.479, 95% CI -0.801 to -0.156, p=0.004) was associated with significantly better improvement in fatigue severity with BWL than with DRL. In contrary, BWL was not associated with significantly different changes in depression severity or quality of life compared with DRL. Finally, BWL was associated with similar acceptability (ie, dropout rate) and safety profile (ie, any discomfort) as those of DRL. CONCLUSIONS This meta-analysis provides an updated evidence on the rationale for application of BWL in ameliorating cancer related fatigue in patients with different types of cancer. TRIAL REGISTRATION NUMBER INPLASY202140090.
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Affiliation(s)
- Chao-Ming Hung
- Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Bing-Syuan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Shian Cheng
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung, Taiwan
| | - Kuan-Pin Su
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Pin-Yang Yeh
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Yutaka J Matsuoka
- Research and Development Division, Health Policy Bureau, Ministry of Health, Labour and Welfare, Tokyo, Japan
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Huang WL, Luo CW, Lin HS, Hung CM, Chen FM, Moi SH, Pan MR. SUV39H1 Expression as a Guideline for Omitting Radiotherapy in Lymph Node-positive Triple-negative Breast Cancer Patients. Cancer Genomics Proteomics 2023; 20:582-591. [PMID: 37889057 PMCID: PMC10614062 DOI: 10.21873/cgp.20407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND/AIM The role of postoperative radiotherapy (RT) combined with chemotherapy (CT) for lymph node-positive (LN+) triple-negative breast cancer (TNBC) remains controversial. SUV39H1-mediated epigenetic regulation is associated with cancer cell migration, invasion, metastasis, and treatment resistance. This study aims to identify the role of SUV39H1 in TNBCs. MATERIALS AND METHODS Overall, 498 TNBCs with SUV39H1 RNA-seq profiles were retrieved from TCGA-BRCA and analyzed; the X-tile algorithm was used to stratify the population into low, intermediate, and high SUV39H1. Furthermore, we performed an in vitro clonogenic cell survival assay using the MDA-MB-231 cell line to assess the effects of SUV39H1 on cellular responses. RESULTS The results showed that SUV39H1 was significantly higher in TNBC than normal tissue and luminal subtype breast cancer. Notably, SUV39H1 is significantly expressed in the basal-like 1 (BL1) and immunomodulatory (IM) subgroups, compared to other subtypes. Compared to patients with a low or medium expression of SUV39H1, omitting RT only worsens disease-free survival (DFS) in those with high SUV39H1 expression. The experimental results showed SUV39H1 was suppressed by si-SUV39H1, and SUV39H1 knockdown in MDA-MB-231-IV2-1 cells enhanced the cellular toxicity of doxorubicin and paclitaxel. CONCLUSION Targeting SUV39H1 may provide a potential guiding indication of omitting RT to avoid over-treatment and chemosensitivity for TNBC.
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Affiliation(s)
- Wei-Lun Huang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
- Department of Radiation Oncology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C
| | - Chi-Wen Luo
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C
| | - Huei-Shan Lin
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan, R.O.C
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan, R.O.C
| | - Fang-Ming Chen
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, R.O.C
| | - Sin-Hua Moi
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.;
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
| | - Mei-Ren Pan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.;
- Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
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Chiu SUF, Hung CM, Chiu CC. A commentary on 'Application of machine learning in surgery research: current uses and future directions - editorial'. Int J Surg 2023; 109:3661-3662. [PMID: 37463027 PMCID: PMC10651260 DOI: 10.1097/js9.0000000000000600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/01/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Si-Un Frank Chiu
- Department of Computer Science
- Department of Economics, Brown University, Providence, Rhode Island, USA
| | - Chao-Ming Hung
- Department of General Surgery
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery
- Department of Medical Education and Research, E-Da Cancer Hospital
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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Hung CM, Tai CM, Chiu CC. A commentary on 'Management of leaks following one-anastomosis gastric bypass: an updated systematic review and meta-analysis of 44 318 patients'. Int J Surg 2023; 109:3705-3706. [PMID: 37549055 PMCID: PMC10651239 DOI: 10.1097/js9.0000000000000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chi-Ming Tai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine
- School of Medicine for International Students
| | - Chong-Chi Chiu
- Department of General Surgery
- Department of Medical Education and Research, E-Da Cancer Hospital
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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Sadahiro R, Matsuoka LN, Zeng BS, Chen KH, Zeng BY, Wang HY, Chu CS, Stubbs B, Su KP, Tu YK, Wu YC, Lin PY, Chen TY, Chen YW, Suen MW, Hopwood M, Yang WC, Sun CK, Cheng YS, Shiue YL, Hung CM, Matsuoka YJ, Tseng PT. Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis. Menopause 2023; 30:766-773. [PMID: 37192826 DOI: 10.1097/gme.0000000000002196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE Menopausal symptoms are common in midlife women and have broad impacts on their daily functioning and quality of life. Black cohosh extracts have been widely used to relieve menopausal symptoms. However, the comparative benefits of different combined black cohosh regimens remain inconclusive. The aim of the current updated meta-analysis is to address the comparative efficacies of different black cohosh regimens in improving menopausal symptoms. METHODS Random-effect model pairwise meta-analysis of randomized controlled trials was conducted to investigate the treatment effect on menopausal symptoms by the black cohosh extract both alone or combined with other related active ingredients. The outcomes studied were changes in menopausal symptoms after treatment with black cohosh extracts in menopausal women. RESULTS Twenty-two articles including information on 2,310 menopausal women were included in the analyses. Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges' g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges' g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges' g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo. However, black cohosh did not significantly improve anxiety (Hedges' g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges' g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131). The dropout rate for black cohosh products was similar to that for placebo (odds ratio = 0.911, 95% CI = 0.660 to 1.256, P = 0.568). CONCLUSIONS This study provides updated evidence regarding the potentially beneficial effects of black cohosh extracts for relieving menopausal symptoms in menopausal women.
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Affiliation(s)
- Ryoichi Sadahiro
- From the Department of Immune Medicine, National Cancer Center Research Institute, National Cancer Center Japan, Tokyo, Japan
| | | | | | - Keng-Hsu Chen
- Department of Medical Education, E-Da Hospital, I-Shou University, E-Da Healthcare Group, Kaohsiung, Taiwan
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Hung-Yu Wang
- Department of Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | | | | | | | | | - Yi-Cheng Wu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | | | | | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung City, Taiwan
| | | | | | | | | | | | - Yow-Ling Shiue
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | | | - Yutaka J Matsuoka
- Center for Public Health Sciences, National Cancer Center Japan, Japan
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Hung CM, Tsai TH, Lee KT, Hsu YC. Sulforaphane-Induced Cell Mitotic Delay and Inhibited Cell Proliferation via Regulating CDK5R1 Upregulation in Breast Cancer Cell Lines. Biomedicines 2023; 11:biomedicines11040996. [PMID: 37189614 DOI: 10.3390/biomedicines11040996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 05/17/2023] Open
Abstract
Our research has revealed that sulforaphane (SFN) has chemopreventive properties and could be used in chemotherapy treatments. Further investigation is needed to understand the mechanisms behind sulforaphane's (SFN) antitumor activity in breast adenocarcinoma, as observed in our studies. This research looked into the effects of SFN on mitosis delay and cell cycle progression in MDA-MB-231 and ZR-75-1 cells, two types of triple-negative breast cancer adenocarcinoma.The proliferation of the cancer cells after SFN exposure was evaluated using MTT assay, DNA content and cell cycle arrest induction by flow cytometry, and expressions of cdc25c, CDK1, cyclin B1 and CDK5R1 were assessed through qRT-PCR and Western blot analysis. SFN was found to inhibit the growth of cancer cells. The accumulation of G2/M-phase cells in SFN-treated cells was attributed to CDK5R1. The disruption of the CDC2/cyclin B1 complex suggested that SFN may have antitumor effects on established breast adenocarcinoma cells. Our findings suggest that, in addition to its chemopreventive properties, SFN could be used as an anticancer agent for breast cancer, as it was found to inhibit growth and induce apoptosis of cancer cells.
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Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 824, Taiwan
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Tai-Hsin Tsai
- Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Kuan-Ting Lee
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Division of Neurosurgery, Department of Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 801, Taiwan
| | - Yi-Chiang Hsu
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
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10
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Hung CM, Hung KC, Shi HY, Su SB, Lee HM, Hsieh MC, Tseng CH, Lin SE, Chen CC, Tseng CM, Tsai YN, Chen CZ, Tsai JF, Chiu CC. Medium-term surgical outcomes and health-related quality of life after laparoscopic vs open colorectal cancer resection: SF-36 health survey questionnaire. World J Gastrointest Endosc 2023; 15:163-176. [PMID: 37034974 PMCID: PMC10080551 DOI: 10.4253/wjge.v15.i3.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/12/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Previous studies that compared the postoperative health-related quality of life (HRQoL) outcomes after receiving laparoscopic resection (LR) or open resection (OR) in patients with colorectal cancer (CRC) have different conclusions.
AIM To explore the medium-term effect of postoperative HRQoL in such patients.
METHODS This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR groups. HRQoL was assessed during the preoperative period and 3, 6, and 12 mo postoperative using a modified version of the 36-Item Short Form (SF-36) Health Survey questionnaire, emphasizing eight specific items.
RESULTS This cohort randomly assigned 541 patients to receive LR (n = 296) or OR (n = 245) surgical procedures. More episodes of postoperative urinary tract infection (P < 0.001), wound infection (P < 0.001), and pneumonia (P = 0.048) were encountered in the OR group. The results demonstrated that the LR group subjectively gained mildly better general health (P = 0.045), moderately better physical activity (P = 0.006), and significantly better social function recovery (P = 0.0001) 3 mo postoperatively. Only the aspect of social function recovery was claimed at 6 mo, with a significant advantage in the LR group (P = 0.001). No clinical difference was found in HRQoL during the 12 mo.
CONCLUSION Our results demonstrated that LR resulted in better outcomes, including intra-operative blood loss, surgery-related complications, course of recovery, and especially some health domains of HRQoL at least within 6 mo postoperatively. Patients should undergo LR if there is no contraindication.
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Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan 71004, Taiwan
- Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan
- Department of Occupational Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan
- Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Meng-Che Hsieh
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Hematology-Oncology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Cheng-Hao Tseng
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Shung-Eing Lin
- Department of Colon and Rectal Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Chih-Cheng Chen
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Chao-Ming Tseng
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Ying-Nan Tsai
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Chi-Zen Chen
- Department of Gastroenterology and Hepatology, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
| | - Jung-Fa Tsai
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung 80794, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Medical Education and Research, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- Department of General Surgery, Chi Mei Medical Center, Liouying 73657, Taiwan
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11
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Hsieh PM, Hsiao P, Chen YS, Yeh JH, Hung CM, Lin HY, Ma CH, Tang T, Huang YW, Cheng PN, Hsieh KC, Hu KC, Bair MJ, Lin CW. Clinical prognosis of surgical resection versus transarterial chemoembolization for single large hepatocellular carcinoma (≥5 cm): A propensity score matching analysis. Kaohsiung J Med Sci 2023; 39:302-310. [PMID: 36625289 DOI: 10.1002/kjm2.12640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/04/2022] [Accepted: 12/11/2022] [Indexed: 01/11/2023] Open
Abstract
Favorable prognostic factors and therapeutic strategies are important for patients with single large hepatocellular carcinoma (HCC). This retrospective study aimed to investigate the prognostic factors in patients with single large (≥5 cm) HCC with Child-Pugh (CP) class A patients and to recommend therapeutic strategies. Overall, 298 HCC patients with single and large (≥5 cm) tumors with CP class A, but without distant metastasis and macrovascular invasion were included, and their clinicopathological data, overall survival (OS), and progression-free survival (PFS) were recorded. OS and PFS was analyzed by the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. The 298 HCC patients were 79.2% male and median age of 64 years. For the initial treatment, surgical resection (SR) and transarterial chemoembolization (TACE) was 50.8% and 49.2%, respectively. The OS and PFS were significantly higher in patients receiving SR than those receiving TACE before and after PSM. Furthermore, in multivariate analysis, cirrhosis (Hazard ratio [HR]: 2.04; 95% confidence interval [CI]: 1.35-3.03, p < 0.001, CP class A5/6 [HR: 4.01; 95% CI: 2.43-6.66, p < 0.001], and initial treatment [SR vs. TACE HR = 3.23; 95% CI: 2.13-5.01, p < 0.001]) remained significantly associated with mortality. Moreover, in multivariate analysis, CP class A5/6 (HR: 3.23; 95% CI: 1.89-5.88, p < 0.001), and initial treatment (Resection vs. TACE; HR = 4.17; 95% CI: 1.64-8.33, p = 0.039) remained significantly associated with recurrence. In conclusion, SR was associated with significantly higher OS and PFS rates than TACE before and after PSM for single large HCC patients.
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Affiliation(s)
- Pei-Min Hsieh
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Pojen Hsiao
- Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yaw-Sen Chen
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Jen-Hao Yeh
- Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Hung-Yu Lin
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Hou Ma
- Department of Orthopedic Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - TaoQian Tang
- Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yu Wei Huang
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Emergency and Critical Care Center, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Nursing, Fooyin University, Pingtung, Taiwan
| | - Pin-Nan Cheng
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Kun-Chou Hsieh
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Kuang-Chun Hu
- Healthy Evaluation Center and Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, New Taipei, Taiwan
| | - Ming-Jong Bair
- Mackay Medical College, New Taipei, Taiwan.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung, Taiwan
| | - Chih-Wen Lin
- Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Health Examination Center, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Research Center for Traditional Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
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12
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Chang KT, Hung CM, Hsu LY, Yeh LR, Yang MC, Chiu CC. Comment on: Shared decision-making should be a standard part of surgical care. Br J Surg 2023; 110:389. [PMID: 36640134 DOI: 10.1093/bjs/znac464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023]
Affiliation(s)
- Kai-Ting Chang
- Department of Family Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.,College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Li-Yu Hsu
- Department of Nursing, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Li-Ren Yeh
- Department of Anaesthesiology, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.,Department of Medical Imaging and Radiological Science, I-Shou University, Kaohsiung, Taiwan
| | - Ming-Chieh Yang
- Department of Critical Care Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Medical Education and Research, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
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13
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Tseng PT, Chen YW, Zeng BY, Zeng BS, Hung CM, Sun CK, Cheng YS, Stubbs B, Carvalho AF, Brunoni AR, Su KP, Tu YK, Wu YC, Chen TY, Lin PY, Liang CS, Hsu CW, Chu CS, Suen MW, Li CT. The beneficial effect on cognition of noninvasive brain stimulation intervention in patients with dementia: a network meta-analysis of randomized controlled trials. Alzheimers Res Ther 2023; 15:20. [PMID: 36698219 PMCID: PMC9875424 DOI: 10.1186/s13195-023-01164-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 08/29/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Dementia [i.e., Alzheimer disease (AD)], the most common neurodegenerative disease, causes profound negative impacts on executive function and quality of life. Available pharmacological treatments often fail to achieve satisfactory outcomes. Noninvasive brain stimulation (NIBS) techniques, which focally modify cortical function and enhance synaptic long-term potentiation, are potentially beneficial for the cognition in patients with AD. The aim of the current network meta-analysis (NMA) was to evaluate the efficacy and safety of different NIBS interventions in patients with AD through NMA. METHODS Only randomized controlled trials (RCTs) examining NIBS interventions in patients with AD had been included. All NMA procedures were performed under the frequentist model. The primary and secondary outcomes were changes in cognitive function and quality of life, respectively. RESULTS Nineteen RCTs (639 participants) were included. The mean treatment and follow-up durations were 5.7 and 10.5 weeks, respectively. The combination of cathodal tDCS of the left dorsolateral prefrontal cortex and anodal tDCS over the right supraorbital region (c-tDCS-F3 + a-tDCS-Fp2) was associated with a significant beneficial effect on cognition compared with sham controls (standardized mean difference=2.43, 95% confidence interval=0.61-4.26, n=12 and 11). It was also associated with the greatest beneficial effect on cognition among all the investigated NIBS approaches. All the methods were well tolerated with regard to the safety profile, as reflected in the rates of adverse events or local discomfort, as well as acceptability, as indicated by dropout rate. CONCLUSIONS The present findings provide evidence of the benefits of NIBS, especially tDCS, for beneficial effect on cognition in patients with AD. However, because of few studies included, this effect was not replicated yet in the other studies. Therefore, future larger-scale and longer follow-up duration RCTs should be warranted. TRIAL REGISTRATION PROSPERO CRD42020209516. The current study had been approved by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. B-109-29).
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Affiliation(s)
- Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan ,grid.412036.20000 0004 0531 9758Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan ,grid.252470.60000 0000 9263 9645Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan ,grid.278247.c0000 0004 0604 5314Division of Community & Rehabilitation Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11267 Taiwan ,grid.412036.20000 0004 0531 9758Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan
| | - Bing-Yan Zeng
- grid.411447.30000 0004 0637 1806Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Bing-Syuan Zeng
- grid.411447.30000 0004 0637 1806Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- grid.411447.30000 0004 0637 1806Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan ,grid.411447.30000 0004 0637 1806School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Cheuk-Kwan Sun
- grid.411447.30000 0004 0637 1806Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan ,grid.411447.30000 0004 0637 1806I-Shou University School of Medicine for International Students, Kaohsiung, Taiwan
| | - Yu-Shian Cheng
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Kaohsiung, Taiwan
| | - Brendon Stubbs
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK ,grid.5115.00000 0001 2299 5510Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK
| | - Andre F. Carvalho
- grid.414257.10000 0004 0540 0062Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC Australia
| | - Andre R. Brunoni
- grid.11899.380000 0004 1937 0722Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da USP, São Paulo, Brazil ,grid.11899.380000 0004 1937 0722Departamento de Ciências Médicas, Faculdade de Medicina da USP, São Paulo, Brazil
| | - Kuan-Pin Su
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Kaohsiung, Taiwan ,grid.411508.90000 0004 0572 9415Mind-Body Interface Laboratory (MBI-Lab), China Medical University and Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Kang Tu
- grid.19188.390000 0004 0546 0241Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan ,grid.412094.a0000 0004 0572 7815Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Cheng Wu
- grid.452620.7Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Tien-Yu Chen
- grid.260565.20000 0004 0634 0356Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan
| | - Pao-Yen Lin
- grid.145695.a0000 0004 1798 0922Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan ,grid.145695.a0000 0004 1798 0922Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- grid.260565.20000 0004 0634 0356Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan ,grid.260565.20000 0004 0634 0356Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Wei Hsu
- grid.145695.a0000 0004 1798 0922Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Che-Sheng Chu
- grid.415011.00000 0004 0572 9992Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan ,grid.415011.00000 0004 0572 9992Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Mein-Woei Suen
- grid.252470.60000 0000 9263 9645Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan ,grid.252470.60000 0000 9263 9645Gender Equality Education and Research Center, Asia University, Taichung, Taiwan ,grid.252470.60000 0000 9263 9645Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Cheng-Ta Li
- grid.278247.c0000 0004 0604 5314Division of Community & Rehabilitation Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11267 Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.278247.c0000 0004 0604 5314Functional Neuroimaging and Brain Stimulation Lab, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11267 Taiwan
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14
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Lu K, Lui CC, Wu YY, Chu SA, Huang R, Chiu CC, Hung CM. Chronologically clustered osteoporotic vertebral compression fractures: Analysis of a case series. Geriatr Gerontol Int 2023; 23:44-49. [PMID: 36484089 DOI: 10.1111/ggi.14518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/23/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022]
Abstract
AIM To provide quality care to older adults, healthcare professionals should be aware that osteoporotic vertebral compression fractures (OVCFs) might occur sequentially in the same patient, involving different vertebral bodies, each separated by short intervals. This situation is called chronologically clustered OVCFs (CCOVCF). METHODS A total of 40 patients with CCOVCFs (index cohort) were retrospectively analyzed, and compared with 40 patients having only one OVCF (comparison cohort). All fractures were treated with percutaneous balloon kyphoplasty. RESULTS In the index cohort, the number of patients having the second, third, fourth and fifth OVCF events within 3 months were 40, 15, five and two, respectively. Recurring pain or seemingly non-stop pain were the major reasons why new OCVFs were found. The average interval between pain relief provided by percutaneous balloon kyphoplasty and radiographic diagnosis of new OVCFs was significantly longer than that between pain relief and a new episode of disabling pain (26.7 ± 16.8 vs 16.4 ± 15.8 days, P < 0.0001), reflecting how shortly new OCVFs occurred after successful surgery, and how often they were neglected. The mean T-score of the index cohort was significantly lower than that of the comparison cohort (-3.66 ± 0.79 vs -3.17 ± 0.80, P = 0.01). CONCLUSIONS CCOVCFs make a patient seem constantly in pain, despite repeated admissions and operations. Recurrent symptoms after an effective procedure should be taken as a warning that a new OCVF might have occurred, even if only a few days apart. Advanced osteoporosis is a significant risk factor for CCOVCFs. Geriatr Gerontol Int 2023; 23: 44-49.
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Affiliation(s)
- Kang Lu
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Chun-Chung Lui
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Division of Medical Image, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Yu-Ying Wu
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Shao-Ang Chu
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Ruyi Huang
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.,Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
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15
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Hung CM, Hung KC, Lee PH, Lu K, Hsieh MC, Chiu CC. Comment on: Environmental sustainability in robotic and laparoscopic surgery: systematic review. Br J Surg 2022; 110:120. [PMID: 36327424 DOI: 10.1093/bjs/znac369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.,Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Kang Lu
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Meng-Che Hsieh
- College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Hematology & Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung, Taiwan
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16
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Wu YY, Chen PY, Wu CC, Chen HJ, Liang CL, Lee YC, Lin CW, Hung CM, Lin IF, Wang HK. Long-term mortality rates of young stroke in Taiwan: A decade-long epidemiology population-based study. Eur Stroke J 2022; 7:447-455. [PMID: 36478751 PMCID: PMC9720855 DOI: 10.1177/23969873221115268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/04/2022] [Indexed: 09/08/2023] Open
Abstract
INTRODUCTION Stroke remains a leading cause of death worldwide. Stroke in young adults is an important issue, gaining extra attention in recent years. This study aims to investigate the mortality after stroke in young adults in Taiwan. PATIENTS AND METHODS This is a registry- and population-based study in Taiwan of patients aged 20-50 years with first-ever stroke between 1999 and 2012, with follow-up until January 1, 2022. Patients and mortalities were identified through Taiwan National Health Insurance database. RESULTS The study population included 65,097 patients with stroke (mean age, 42.6 ± 6.6 years; 30.5% woman). There were 23,481 (36.1%) intracranial hemorrhage, 37,522 (57.6%) ischemic stroke, and 4094 (6.3%) stroke not otherwise specified. At the end of follow-up, a total of 18,248 deaths (28.0%) occurred during a median follow-up of 9.8 years (interquartile range, 6.4-13.7 years). CONCLUSION Taiwan young adults who were 30-day survivors of first-ever stroke have significantly higher long-term mortality rates when compared to other population-based studies.
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Affiliation(s)
- Yu-ying Wu
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
| | - Po-Yuan Chen
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
| | - Cheng-Chun Wu
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
| | - Han-Jung Chen
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
| | - Cheng-Loong Liang
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
| | - Yi-Che Lee
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Nephrology, E-Da
Hospital, Kaohsiung
| | - Chi-Wei Lin
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Family Medicine, E-Da
Hospital, Kaohsiung
| | - Chao-Ming Hung
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of General Surgery, E-Da
cancer Hospital, Kaohsiung
| | - I-Fan Lin
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Infectious Disease, E-Da
Hospital, Kaohsiung
| | - Hao-Kuang Wang
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
- Department of Neurosurgery, E-Da Cancer
Hospital, Kaohsiung
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Hung CM, Hung KC, Lee PH, Tsai IT, Lee HM, Chiu CC. Comment on: Tranexamic acid for safer surgery: the time is now. Br J Surg 2022; 109:e130. [PMID: 36151842 DOI: 10.1093/bjs/znac331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Kuo-Chuan Hung
- Department of Anaesthesiology, Chi Mei Medical Centre, Tainan, Taiwan.,Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - I Ting Tsai
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Emergency, E-Da Hospital, Kaohsiung, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.,College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung, Taiwan
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18
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Hung CM, Hung KC, Lin JT, Rau KM, Lee HM, Chiu CC. Comment on: Histopathological assessment of the gallbladder after routine cholecystectomy is essential for high-quality healthcare. Br J Surg 2022; 109:e129. [PMID: 36052605 DOI: 10.1093/bjs/znac312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Jaw-Town Lin
- Department of Gastroenterology and Hepatology, E-Da Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Kun-Ming Rau
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Hematology and Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung, Taiwan
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Liu CF, Hung CM, Ko SC, Cheng KC, Chao CM, Sung MI, Hsing SC, Wang JJ, Chen CJ, Lai CC, Chen CM, Chiu CC. An artificial intelligence system to predict the optimal timing for mechanical ventilation weaning for intensive care unit patients: A two-stage prediction approach. Front Med (Lausanne) 2022; 9:935366. [PMID: 36465940 PMCID: PMC9715756 DOI: 10.3389/fmed.2022.935366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/11/2022] [Indexed: 11/03/2023] Open
Abstract
Background For the intensivists, accurate assessment of the ideal timing for successful weaning from the mechanical ventilation (MV) in the intensive care unit (ICU) is very challenging. Purpose Using artificial intelligence (AI) approach to build two-stage predictive models, namely, the try-weaning stage and weaning MV stage to determine the optimal timing of weaning from MV for ICU intubated patients, and implement into practice for assisting clinical decision making. Methods AI and machine learning (ML) technologies were used to establish the predictive models in the stages. Each stage comprised 11 prediction time points with 11 prediction models. Twenty-five features were used for the first-stage models while 20 features were used for the second-stage models. The optimal models for each time point were selected for further practical implementation in a digital dashboard style. Seven machine learning algorithms including Logistic Regression (LR), Random Forest (RF), Support Vector Machines (SVM), K Nearest Neighbor (KNN), lightGBM, XGBoost, and Multilayer Perception (MLP) were used. The electronic medical records of the intubated ICU patients of Chi Mei Medical Center (CMMC) from 2016 to 2019 were included for modeling. Models with the highest area under the receiver operating characteristic curve (AUC) were regarded as optimal models and used to develop the prediction system accordingly. Results A total of 5,873 cases were included in machine learning modeling for Stage 1 with the AUCs of optimal models ranging from 0.843 to 0.953. Further, 4,172 cases were included for Stage 2 with the AUCs of optimal models ranging from 0.889 to 0.944. A prediction system (dashboard) with the optimal models of the two stages was developed and deployed in the ICU setting. Respiratory care members expressed high recognition of the AI dashboard assisting ventilator weaning decisions. Also, the impact analysis of with- and without-AI assistance revealed that our AI models could shorten the patients' intubation time by 21 hours, besides gaining the benefit of substantial consistency between these two decision-making strategies. Conclusion We noticed that the two-stage AI prediction models could effectively and precisely predict the optimal timing to wean intubated patients in the ICU from ventilator use. This could reduce patient discomfort, improve medical quality, and lower medical costs. This AI-assisted prediction system is beneficial for clinicians to cope with a high demand for ventilators during the COVID-19 pandemic.
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Affiliation(s)
- Chung-Feng Liu
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Shian-Chin Ko
- Department of Respiratory Therapy, Chi Mei Medical Center, Tainan, Taiwan
| | - Kuo-Chen Cheng
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chien-Ming Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Taiwan
- Department of Dental Laboratory Technology, Min-Hwei College of Health Care Management, Liouying, Taiwan
| | - Mei-I Sung
- Department of Respiratory Therapy, Chi Mei Medical Center, Tainan, Taiwan
| | - Shu-Chen Hsing
- Department of Respiratory Therapy, Chi Mei Medical Center, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Anesthesiology, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Jung Chen
- Department of Information Systems, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chin-Ming Chen
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung, Taiwan
- Department of General Surgery, Chi Mei Medical Center, Tainan, Taiwan
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20
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Hung CM, Lee PH, Lu K, Chiu CC. Comment on "Sutured Versus Mesh-augmented Hiatus Hernia Repair: A Systematic Review and Meta-analysis of Randomized Controlled Trials". Ann Surg Open 2022; 3:e173. [PMID: 37601144 PMCID: PMC10431498 DOI: 10.1097/as9.0000000000000173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 01/29/2022] [Indexed: 10/18/2022] Open
Affiliation(s)
- Chao-Ming Hung
- From the Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Kang Lu
- Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- From the Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung, Taiwan
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21
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Tseng PT, Zeng BS, Hung CM, Liang CS, Stubbs B, Carvalho AF, Brunoni AR, Su KP, Tu YK, Wu YC, Chen TY, Li DJ, Lin PY, Hsu CW, Chen YW, Suen MW, Satogami K, Takahashi S, Wu CK, Yang WC, Shiue YL, Huang TL, Li CT. Assessment of Noninvasive Brain Stimulation Interventions for Negative Symptoms of Schizophrenia: A Systematic Review and Network Meta-analysis. JAMA Psychiatry 2022; 79:770-779. [PMID: 35731533 PMCID: PMC9218931 DOI: 10.1001/jamapsychiatry.2022.1513] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
IMPORTANCE Negative symptoms have a detrimental impact on functional outcomes and quality of life in people with schizophrenia, and few therapeutic options are considered effective for this symptomatic dimension. Studies have suggested that noninvasive brain stimulation (NIBS) interventions may be effective in treating negative symptoms. However, the comparative efficacy of different NIBS protocols for relieving negative symptoms remains unclear. OBJECTIVE To compare the efficacy and acceptability of different NIBS interventions for treating negative symptoms. DATA SOURCES The ClinicalKey, Cochrane CENTRAL, Embase, ProQuest, PubMed, ScienceDirect, ClinicalTrials.gov, and Web of Science electronic databases were systematically searched from inception through December 7, 2021. STUDY SELECTION A frequentist model network meta-analysis was conducted to assess the pooled findings of trials that evaluated the efficacy of repetitive transcranial magnetic stimulation (rTMS), theta-burst stimulation, transcranial random noise stimulation, transcutaneous vagus nerve stimulation, and transcranial direct current stimulation on negative symptoms in schizophrenia. Randomized clinical trials (RCTs) examining NIBS interventions for participants with schizophrenia were included. DATA EXTRACTION AND SYNTHESIS The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed. Data were independently extracted by multiple observers. The pair-wise meta-analytic procedures were conducted using a random-effects model. MAIN OUTCOMES AND MEASURES The coprimary outcomes were changes in the severity of negative symptoms and acceptability (ie, dropout rates owing to any reason). Secondary outcomes were changes in positive and depressive symptoms. RESULTS Forty-eight RCTs involving 2211 participants (mean [range] age, 38.7 [24.0-57.0] years; mean [range] proportion of female patients, 30.6% [0%-70.0%]) were included. Compared with sham control interventions, excitatory NIBS strategies (standardized mean difference [SMD]: high-definition transcranial random noise stimulation, -2.19 [95% CI, -3.36 to -1.02]; intermittent theta-burst stimulation, -1.32 [95% CI, -1.88 to -0.76]; anodal transcranial direct current stimulation, -1.28 [95% CI, -2.55 to -0.02]; high-frequency rTMS, -0.43 [95% CI, -0.68 to -0.18]; extreme high-frequency rTMS, -0.45 [95% CI, -0.79 to -0.12]) over the left dorsolateral prefrontal cortex with or without other inhibitory stimulation protocols in the contralateral regions of the brain were associated with significantly larger reductions in negative symptoms. Acceptability did not significantly differ between the groups. CONCLUSIONS AND RELEVANCE In this network meta-analysis, excitatory NIBS protocols over the left dorsolateral prefrontal cortex were associated with significantly large improvements in the severity of negative symptoms. Because relatively few studies were available for inclusion, additional well-designed, large-scale RCTs are warranted.
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Affiliation(s)
- Ping-Tao Tseng
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan,Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bing-Syuan Zeng
- Department of Internal Medicine, E-DA Cancer Hospital, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Andre F. Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Andre R. Brunoni
- Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil,Departamento de Ciências Médicas, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil
| | - Kuan-Pin Su
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom,Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan,College of Medicine, China Medical University, Taichung, Taiwan,An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Mein-Woei Suen
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan,Gender Equality Education and Research Center, Asia University, Taichung, Taiwan,Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Kazumi Satogami
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan,Clinical Research and Education Center, Asakayama General Hospital, Sakai, Japan,Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino, Japan,Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan,Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Japan
| | - Ching-Kuan Wu
- Department of Psychiatry, Kaohsiung Kingswood Psychiatric Clinic, Kaohsiung, Taiwan
| | - Wei-Cheng Yang
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan,Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Yow-Ling Shiue
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Tiao-Lai Huang
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,Department of Psychiatry, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan,Genomic and Proteomic Core Laboratory, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Chuang CS, Chen YW, Zeng BY, Hung CM, Tu YK, Tai YC, Wu YC, Hsu CW, Lei WT, Wu SL, Stubbs B, Carvalho AF, Su KP, Chen TY, Tseng PT, Wu MK, Tsai CH. Effects of modern technology (exergame and virtual reality)-assisted rehabilitation vs conventional rehabilitation in patients with Parkinson’s disease: a network meta-analysis of randomised controlled trials. Physiotherapy 2022; 117:35-42. [DOI: 10.1016/j.physio.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 06/04/2022] [Accepted: 07/12/2022] [Indexed: 01/08/2023]
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Zeng BS, Zeng BY, Hung CM, Kuo HC, Chen YW, Suen MW, Shiue YL, Tseng PT, Chen CH. The efficacy and tolerability of antibiotics in scrub typhus: An updated network meta-analysis of randomized controlled trials. Int J Infect Dis 2022; 122:461-468. [PMID: 35724826 DOI: 10.1016/j.ijid.2022.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/06/2022] [Accepted: 06/14/2022] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION Inadequate treatment of scrub typhus results in severe complications such as septic shock and is also associated with a high median mortality rate of 6%. However, there has been no conclusive evidence about the superiority of different antibiotics in managing scrub typhus in terms of efficacy and tolerability. METHODS The current network meta-analysis (NMA) was conducted using the frequentist method. The included participants were pediatric and adult patients infected with scrub typhus. The primary outcome was the cure rate in the patients included. The subgroup analysis was done according to pediatric or adult patients. RESULTS Overall, 14 randomized controlled trials (RCTs) with 1264 participants were included in this study. The NMA revealed that all the investigated antibiotics were associated with cure rates similar to those of doxycycline. The chloramphenicol and minocycline were ranked to be associated with the highest cure rate in the pediatric subgroup and adult subgroup, respectively. Second-generation quinolones, including ofloxacin and ciprofloxacin and chloramphenicol were associated with significantly lower adverse event rates than doxycycline. CONCLUSION The current update NMA provides evidence for the efficacy of chloramphenicol and minocycline in scrub typhus management. However, future large-scale RCTs with longer follow-up times are warranted. TRIAL REGISTRATION PROSPERO CRD42020222410. The current study was approved by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. B-109-29).
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Affiliation(s)
- Bing-Syuan Zeng
- Department of Internal Medicine, E-DA Cancer Hospital, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Bing-Yan Zeng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Internal Medicine, E-DA Dachang Hospital, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Hung-Chang Kuo
- Department of Neurology, E-Da Cancer Hospital/School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Mein-Woei Suen
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Gender Equality Education and Research Center, Asia University, Taichung, Taiwan; Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yow-Ling Shiue
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan.
| | - Ping-Tao Tseng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan; Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - Chang-Hua Chen
- Program in Translational Medicine, National Chung Hsing University, Taichung City, Taiwan; Rong Hsing Research Center For Translational Medicine, National Chung Hsing University, Taichung City, Taiwan; Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
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24
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Wang SH, Wu CH, Tsai CC, Chen TY, Tsai KJ, Hung CM, Hsu CY, Wu CW, Hsieh TH. Effects of Luteolin on Human Breast Cancer Using Gene Expression Array: Inferring Novel Genes. Curr Issues Mol Biol 2022; 44:2107-2121. [PMID: 35678671 PMCID: PMC9164068 DOI: 10.3390/cimb44050142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 11/24/2022] Open
Abstract
Taraxacum officinale (dandelion) is often used in traditional Chinese medicine for the treatment of cancer; however, the downstream regulatory genes and signaling pathways mediating its effects on breast cancer remain unclear. The present study aimed to explore the effects of luteolin, the main biologically active compound of T. officinale, on gene expression profiles in MDA-MB-231 and MCF-7 breast cancer cells. The results revealed that luteolin effectively inhibited the proliferation and motility of the MDA-MB-231 and MCF-7 cells. The mRNA expression profiles were determined using gene expression array analysis and analyzed using a bioinformatics approach. A total of 41 differentially expressed genes (DEGs) were found in the luteolin-treated MDA-MB-231 and MCF-7 cells. A Gene Ontology analysis revealed that the DEGs, including AP2B1, APP, GPNMB and DLST, mainly functioned as oncogenes. The human protein atlas database also found that AP2B1, APP, GPNMB and DLST were highly expressed in breast cancer and that AP2B1 (cut-off value, 75%) was significantly associated with survival rate (p = 0.044). In addition, a Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that the DEGs were involved in T-cell leukemia virus 1 infection and differentiation. On the whole, the findings of the present study provide a scientific basis that may be used to evaluate the potential benefits of luteolin in human breast cancer. Further studies are required, however, to fully elucidate the role of the related molecular pathways.
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Affiliation(s)
- Shih-Ho Wang
- Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
- Division of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Chin-Hu Wu
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (C.-H.W.); (C.-Y.H.)
| | - Chin-Chuan Tsai
- Department of Chinese Medicine, E-Da Hospital, Kaohsiung 82445, Taiwan; (C.-C.T.); (T.-Y.C.)
| | - Tai-Yu Chen
- Department of Chinese Medicine, E-Da Hospital, Kaohsiung 82445, Taiwan; (C.-C.T.); (T.-Y.C.)
| | - Kuen-Jang Tsai
- Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (K.-J.T.); (C.-M.H.)
| | - Chao-Ming Hung
- Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (K.-J.T.); (C.-M.H.)
| | - Chia-Yi Hsu
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (C.-H.W.); (C.-Y.H.)
| | - Chia-Wei Wu
- Department of Medical Research, E-Da Hospital/E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Tsung-Hua Hsieh
- Department of Medical Research, E-Da Hospital/E-Da Cancer Hospital, I-Shou University, Kaohsiung 82445, Taiwan;
- Correspondence: ; Tel.: +886-7-6151100 (ext. 5072)
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Chiu CC, Ishibashi H, Wakama S, Liu Y, Hao Y, Hung CM, Lee PH, Rau KM, Lee HM, Yonemura Y. Mesentery solitary fibrous tumor with postoperative recurrence and sarcomatosis: A case report and review of literature. World J Clin Oncol 2022; 13:303-313. [PMID: 35582654 PMCID: PMC9052071 DOI: 10.5306/wjco.v13.i4.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/20/2022] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Solitary fibrous tumors are rare neoplasms of mesenchymal origin. They are often of low malignant potential and rarely metastasize. They frequently arise from the pleura and can occur at any soft tissue site in the body. However, these tumors rarely develop in the mesentery, peritoneal cavity or peritoneum.
CASE SUMMARY We report on a scarce case of solitary fibrous tumor of the rectal mesentery showing sarcomatosis about 4 years after previous tumor resection. This 69-year-old male had no clinical symptoms but was transferred to our hospital because of a suspected tumor recurrence from follow-up abdominal computed tomography. Tumor markers (CEA, CA 19-9 and CA 125) were within the normal range. Open laparotomy showed sarcomatosis, and pathology confirmed its mesenchymal origin and diagnosis as the solitary fibrous tumor. Our case may be the second recurrent mesentery solitary fibrous tumor reported to date, and the only one with progression to sarcomatosis. There has been no evidence of recurrence in follow-up at the 28th mo after extensive intra-operative peritoneal lavage and cytoreductive surgery.
CONCLUSION Although there are few risk factors of cancer recurrence in this patient, careful long-term follow-up after cytoreductive surgery is necessary.
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Affiliation(s)
- Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
| | - Haruaki Ishibashi
- Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Osaka 596-8522, Japan
| | - Satoshi Wakama
- Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Osaka 596-8522, Japan
| | - Yang Liu
- Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Osaka 596-8522, Japan
| | - Yuan Hao
- Department of General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Po-Huang Lee
- Department of General Surgery, E-Da Hospital, Kaohsiung 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Kun-Ming Rau
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Hematology & Oncology, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Yutaka Yonemura
- Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Osaka 596-8522, Japan
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Hung CM, Lee PH, Chang CS, Rau KM, Tsai JF, Chiu CC. Comment on: Antibiotics as first-line alternative to appendicectomy in adult appendicitis: 90-day follow-up from a prospective, multicentre cohort study. Br J Surg 2022; 109:e76. [PMID: 35233613 DOI: 10.1093/bjs/znac036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/17/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Chao-Sung Chang
- Department of Hematology & Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Kun-Ming Rau
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Hematology & Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Jung-Fa Tsai
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung, Taiwan
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Hung CM, Lee PH, Tai CM, Wang WL, Wu YL, Chiu CC. Comment on: Routine versus selective intraoperative cholangiography during cholecystectomy: systematic review, meta-analysis, and health economic model analysis of iatrogenic bile duct injury. BJS Open 2022; 6:6567626. [PMID: 35415754 PMCID: PMC9005754 DOI: 10.1093/bjsopen/zrac053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/04/2022] [Indexed: 02/07/2023] Open
Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Chi-Ming Tai
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Wen-Lun Wang
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yi-Ling Wu
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- Correspondence to: Chong-Chi Chiu, Department of General Surgery, E-Da Cancer Hospital, No.1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung 824005, Taiwan (e-mail: )
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Hung CM, Shi HY, Lee PH, Chang CS, Rau KM, Lee HM, Tseng CH, Pei SN, Tsai KJ, Chiu CC. Potential and role of artificial intelligence in current medical healthcare. Artif Intell Cancer 2022; 3:1-10. [DOI: 10.35713/aic.v3.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/31/2021] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
Artificial intelligence (AI) is defined as the digital computer or computer-controlled robot's ability to mimic intelligent conduct and crucial thinking commonly associated with intelligent beings. The application of AI technology and machine learning in medicine have allowed medical practitioners to provide patients with better quality of services; and current advancements have led to a dramatic change in the healthcare system. However, many efficient applications are still in their initial stages, which need further evaluations to improve and develop these applications. Clinicians must recognize and acclimate themselves with the developments in AI technology to improve their delivery of healthcare services; but for this to be possible, a significant revision of medical education is needed to provide future leaders with the required competencies. This article reviews the potential and limitations of AI in healthcare, as well as the current medical application trends including healthcare administration, clinical decision assistance, patient health monitoring, healthcare resource allocation, medical research, and public health policy development. Also, future possibilities for further clinical and scientific practice were also summarized.
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Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung 80420, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Surgery, E-Da Hospital, Kaohsiung 82445, Taiwan
| | - Chao-Sung Chang
- Department of Hematology & Oncology, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Kun-Ming Rau
- Department of Hematology & Oncology, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Cheng-Hao Tseng
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- Department of Gastroenterology and Hepatology, E-Da Hospital, Kaohsiung 82445, Taiwan
| | - Sung-Nan Pei
- Department of Hematology & Oncology, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Kuen-Jang Tsai
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
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Cheng YC, Zeng BY, Hung CM, Su KP, Wu YC, Tu YK, Lin PY, Stubbs B, Carvalho AF, Liang CS, Chen TY, Hsu CW, Brunoni AR, Suen MW, Shiue YL, Tseng PT, Wu MK, Li CT. Effectiveness and acceptability of noninvasive brain and nerve stimulation techniques for migraine prophylaxis: a network meta-analysis of randomized controlled trials. J Headache Pain 2022; 23:28. [PMID: 35184742 PMCID: PMC8903676 DOI: 10.1186/s10194-022-01401-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/07/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Current pharmacologic prophylactic strategies for migraine have exhibited limited efficacy, with response rates as low as 40%-50%. In addition to the limited efficacy, the acceptability of those pharmacologic prophylactic strategies were unacceptable. Although noninvasive brain/nerve stimulation strategies may be effective, the evidence has been inconsistent. The aim of this network meta-analysis (NMA) was to compare strategies of noninvasive brain/nerve stimulation for migraine prophylaxis with respect to their effectiveness and acceptability. METHODS The PubMed, Embase, ScienceDirect, ProQuest, ClinicalTrials.gov , ClinicalKey, Cochrane CENTRAL, Web of Science, and ClinicalTrials.gov databases were systematically searched to date of June 4th, 2021 for randomized controlled trials (RCTs). Patients with diagnosis of migraine, either episodic migraine or chronic migraine, were included. All NMA procedures were conducted under the frequentist model. RESULTS Nineteen RCTs were included (N = 1493; mean age = 38.2 years; 82.0% women). We determined that the high frequency repetitive transcranial magnetic stimulation (rTMS) over C3 yielded the most decreased monthly migraine days among all the interventions [mean difference = - 8.70 days, 95% confidence intervals (95%CIs): - 14.45 to - 2.95 compared to sham/control groups]. Only alternating frequency (2/100 Hz) transcutaneous occipital nerve stimulation (tONS) over the Oz (RR = 0.36, 95%CIs: 0.16 to 0.82) yielded a significantly lower drop-out rate than the sham/control groups did. CONCLUSIONS The current study provided a new direction for the design of more methodologically robust and larger RCTs based on the findings of the potentially beneficial effect on migraine prophylaxis in participants with migraine by different noninvasive brain/nerve stimulation, especially the application of rTMS and tONS. TRIAL REGISTRATION CRD42021252638. The current study had been approval by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. B-109-29).
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Affiliation(s)
- Yu-Chen Cheng
- Department of Neurology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Community & Rehabilitation Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-DA Dachang Hospital, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Kuan-Pin Su
- Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist, Kaohsiung City, 833, Taiwan.,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Positive Ageing Research Institute (PARI), Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK
| | - Andre F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist, Kaohsiung City, 833, Taiwan
| | - Andre R Brunoni
- Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da USP, São Paulo, Brazil.,Departamento de Ciências Médicas, Faculdade de Medicina da USP, São Paulo, Brazil
| | - Mein-Woei Suen
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.,Gender Equality Education and Research Center, Asia University, Taichung, Taiwan.,Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yow-Ling Shiue
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Ping-Tao Tseng
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan. .,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan. .,Prospect Clinic for Otorhinolaryngology & Neurology, No. 252, Nanzixin Road, Nanzi District, Kaohsiung City, 81166, Taiwan.
| | - Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist, Kaohsiung City, 833, Taiwan.
| | - Cheng-Ta Li
- Division of Community & Rehabilitation Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan. .,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan. .,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11267, Taiwan. .,Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Functional Neuroimaging and Brain Stimulation Lab, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11267, Taiwan.
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30
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Tsai KJ, Chou MC, Li HM, Liu ST, Hsu JH, Yeh WC, Hung CM, Yeh CY, Hwang SH. A High-Performance Deep Neural Network Model for BI-RADS Classification of Screening Mammography. Sensors (Basel) 2022; 22:s22031160. [PMID: 35161903 PMCID: PMC8838754 DOI: 10.3390/s22031160] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 11/16/2022]
Abstract
Globally, the incidence rate for breast cancer ranks first. Treatment for early-stage breast cancer is highly cost effective. Five-year survival rate for stage 0-2 breast cancer exceeds 90%. Screening mammography has been acknowledged as the most reliable way to diagnose breast cancer at an early stage. Taiwan government has been urging women without any symptoms, aged between 45 and 69, to have a screening mammogram bi-yearly. This brings about a large workload for radiologists. In light of this, this paper presents a deep neural network (DNN)-based model as an efficient and reliable tool to assist radiologists with mammographic interpretation. For the first time in the literature, mammograms are completely classified into BI-RADS categories 0, 1, 2, 3, 4A, 4B, 4C and 5. The proposed model was trained using block-based images segmented from a mammogram dataset of our own. A block-based image was applied to the model as an input, and a BI-RADS category was predicted as an output. At the end of this paper, the outperformance of this work is demonstrated by an overall accuracy of 94.22%, an average sensitivity of 95.31%, an average specificity of 99.15% and an area under curve (AUC) of 0.9723. When applied to breast cancer screening for Asian women who are more likely to have dense breasts, this model is expected to give a higher accuracy than others in the literature, since it was trained using mammograms taken from Taiwanese women.
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Affiliation(s)
- Kuen-Jang Tsai
- Department of General Surgey, E-Da Cancer Hospital, Yanchao Dist., Kaohsiung 82445, Taiwan; (K.-J.T.); (C.-M.H.)
- College of Medicine, I-Shou University, Yanchao Dist., Kaohsiung 82445, Taiwan
| | - Mei-Chun Chou
- Department of Radiology, E-Da Hospital, Yanchao Dist., Kaohsiung 82445, Taiwan; (M.-C.C.); (H.-M.L.); (S.-T.L.); (J.-H.H.)
| | - Hao-Ming Li
- Department of Radiology, E-Da Hospital, Yanchao Dist., Kaohsiung 82445, Taiwan; (M.-C.C.); (H.-M.L.); (S.-T.L.); (J.-H.H.)
| | - Shin-Tso Liu
- Department of Radiology, E-Da Hospital, Yanchao Dist., Kaohsiung 82445, Taiwan; (M.-C.C.); (H.-M.L.); (S.-T.L.); (J.-H.H.)
| | - Jung-Hsiu Hsu
- Department of Radiology, E-Da Hospital, Yanchao Dist., Kaohsiung 82445, Taiwan; (M.-C.C.); (H.-M.L.); (S.-T.L.); (J.-H.H.)
| | - Wei-Cheng Yeh
- Department of Radiology, E-Da Cancer Hospital, Yanchao Dist., Kaohsiung 82445, Taiwan;
| | - Chao-Ming Hung
- Department of General Surgey, E-Da Cancer Hospital, Yanchao Dist., Kaohsiung 82445, Taiwan; (K.-J.T.); (C.-M.H.)
| | - Cheng-Yu Yeh
- Department of Electrical Engineering, National Chin-Yi University of Technology, Taichung 41170, Taiwan
- Correspondence:
| | - Shaw-Hwa Hwang
- Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
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Hung CM, Lee PH, Lee HM, Chiu CC. A commentary on "Gastrectomy with omentum preservation versus gastrectomy with omentectomy for locally advanced gastric cancer: A systematic review and meta-analysis" (Int J Surg 2021 PMID:34763122). Int J Surg 2022; 97:106193. [PMID: 34920146 DOI: 10.1016/j.ijsu.2021.106193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 11/30/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan College of Medicine, I-Shou University, Kaohsiung, Taiwan Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan Department of Medical Education and Research, E-Da Cancer Hospital, Kaohsiung, Taiwan
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Liao KM, Hung CM, Shu CC, Lee HS, Wei YF. Impact of Chronic Obstructive Pulmonary Disease on the Mortality of Patients with Small Cell Lung Cancer. Int J Chron Obstruct Pulmon Dis 2021; 16:3255-3262. [PMID: 34880609 PMCID: PMC8645948 DOI: 10.2147/copd.s328938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background Limited studies have focused on the impact of the coexistence of small cell lung cancer (SCLC) and chronic obstructive pulmonary disease (COPD). The study was to examine the impact of COPD on mortality in SCLC patients. Methods We analyzed SCLC patients from the Taiwan Cancer Registry Database between January 1, 1997, and December 31, 2015. The COPD population was composed of patients with a COPD diagnosis before the diagnosis of SCLC. The control group was composed of randomly selected SCLC patients without COPD who were propensity score matched with those with concomitant COPD according to age, sex, index date, cancer staging and comorbidities at a 1:1 ratio. Results Among 9425 SCLC patients in the database, eligible subjects were divided into the COPD group (n = 4235) and the non-COPD group (n = 2334). Compared to patients in the non-COPD group, the patients in the COPD group were older (71.4 versus 65.7 years, p<0.0001), had a lower percentage of stage IV disease (60.1% versus 68.3%, p<0.0001) and had more comorbidities. After matching, there were 1457 patients in each group. Older age, lower body mass index (BMI), and some comorbidities were associated with higher mortality, and comorbid COPD was associated with lower 1-year mortality in SCLC patients. Multivariate analysis identified older age, lower BMI, and concomitant congestive heart failure or diabetes as risk factors for OS. Conclusion A diagnosis of COPD was associated with reduced 1-year mortality in SCLC patients, but no significant difference after 1-year in this population.
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Affiliation(s)
- Kuang-Ming Liao
- Department of Internal Medicine, Chi Mei Medical Center, Chiali, Tainan, Taiwan
| | - Chao-Ming Hung
- Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Chin-Chung Shu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ho-Sheng Lee
- Division of Chest Medicine, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Yu-Feng Wei
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan
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Hung CC, Huang HI, Hung CM, Moi SH. Identification of Candidate Genes in Early-Stage Invasive Ductal Carcinoma Patients with High-Risk Mortality Using Genes Commonly Involved in Breast Cancer: A Retrospective Study. Public Health Genomics 2021; 25:1-10. [PMID: 34634790 DOI: 10.1159/000519140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 08/09/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Invasive ductal carcinoma (IDC) of the breast is a heterogeneous disease characterized by multiple subtypes. IDC survival is highly impacted by tumor burden, molecular subtypes, and gene profiles. Gene mutation is a type of genomic instability regarded as having a considerable effect on IDC prognosis. Using integrated survival analysis, this study identified candidate genes and a high-risk group of patients with early-stage IDC to provide further understanding of the genetic characteristics associated with poor survival. METHODS The gene mutation profiles, baseline demographics, clinicopathologic variables, and treatment characteristics of the early-stage IDC subpopulation were downloaded from an open access data platform. These data were analyzed for a total of 444 patients. In total, 40 genes commonly involved in IDC were listed, and the genes exhibiting significant differences (as estimated using the log-rank test) were selected as the candidate genes. RESULTS The patients were divided into control, low-risk, and high-risk groups according to their gene mutation profiles. The 5-year overall survival rates of low-risk, control, and high-risk patients were 97.4%, 96.1%, and 73.0%, respectively. The high-risk group had a significantly higher risk of poor overall -survival (adjusted hazard ratio = 6.57, 95% confidence interval = 1.51-28.7, p = 0.012) than that of the control group, and the low-risk group did not have a significant survival difference compared with control group. CONCLUSIONS This study proposed an integrative approach for the identification of candidate genes for risk assessment of overall survival in these patients through typical survival analysis methods. The 14 candidate genes selected are particularly involved in cell-cycle processes, deoxyribonucleic acid repair, and drug resistance; their mutations were found to be generally associated with disease progression or therapeutic resistance, which is commonly associated with poor overall survival outcomes in IDC.
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Affiliation(s)
- Chih-Chiang Hung
- Division of Breast Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Applied Cosmetology, College of Human Science and Social Innovation, Hungkuang University, Taichung, Taiwan
| | - Hsin-I Huang
- Center of Cancer Program Development, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Sin-Hua Moi
- Center of Cancer Program Development, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
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Cheng KH, Wu YW, Hou CJY, Hung CM. An Overview of Cardio-Oncology, a New Frontier to Be Explored. Acta Cardiol Sin 2021; 37:457-463. [PMID: 34584378 DOI: 10.6515/acs.202109_37(5).20210706a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/06/2021] [Indexed: 11/23/2022]
Abstract
Advances in cancer treatments have led to an increasing number of cancer survivors, but also high rates of short- and long-term cardiovascular (CV) toxicities. The number of new cancer drugs is constantly increasing, and the uncertain CV toxicities of these drugs make long-term care and monitoring difficult. Moreover, traditional type I and type II cardiotoxicities may not be applicable to all of these agents. Multidisciplinary care with expertise in oncology, cardiology and other related specialties is required to mitigate cancer therapeutics-related cardiovascular dysfunction (CTRCD). The aim of this review is to provide an overview of the main CTRCD, risk assessment, early diagnosis, and strategies for the prevention and management of patients receiving cancer therapies. There are still unmet needs for cardio- oncology researchers with regards to early detection measures, better treatment strategies, better follow-up protocols, and better management of CTRCD. Experts in cardiology, oncology, hematology, and radio-oncology should thus work closely in an attempt to foster patient awareness and research in this field, as well as call for support from public and industrial sources to initiate pivotal clinical trials to solve these unmet needs.
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Affiliation(s)
- Kai-Hung Cheng
- Division of Cardiology, Department of Internal Medicine, E-Da Cancer Hospital.,College of Medicine, I-Shou University, Kaohsiung
| | - Yen-Wen Wu
- Department of Nuclear Medicine.,Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City.,School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Charles Jia-Yin Hou
- Department of Medicine, MacKay Medical College, New Taipei City.,Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei
| | - Chao-Ming Hung
- College of Medicine, I-Shou University, Kaohsiung.,Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
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Chen JJ, Chen YW, Zeng BY, Hung CM, Zeng BS, Stubbs B, Carvalho AF, Thompson T, Roerecke M, Su KP, Tu YK, Wu YC, Smith L, Chen TY, Lin PY, Liang CS, Hsu CW, Hsu SP, Kuo HC, Wu MK, Tseng PT. Efficacy of pharmacologic treatment in tinnitus patients without specific or treatable origin: A network meta-analysis of randomised controlled trials. EClinicalMedicine 2021; 39:101080. [PMID: 34611615 PMCID: PMC8478678 DOI: 10.1016/j.eclinm.2021.101080] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although tinnitus has a prevalence between 20 and 42.8%, the currently recommended management for tinnitus, such as tinnitus support and psychologic therapies, are relatively time-consuming and expensive. Several new pharmacologic treatments designed for tinnitus patients without specific origin had been developed but their efficacy remains unclear. METHODS The current Network Meta-Analysis (NMA) of randomised controlled trials (RCTs) was conducted to evaluate the efficacy of different pharmacologic treatments for tinnitus management in tinnitus patients without specific or treatable origin (i.e. primary tinnitus). Databases were searched from inception to April 5th, 2021. All network meta-analytic procedures were conducted under the frequentist model. We calculated the effect size of outcomes with different rating scales with standardized mean difference. PROSPERO registration: CRD42020177742. FINDINGS Overall, 36 RCTs were included with 2,761 participants. The main results revealed that pharmacologic interventions with brain-acting effect (for example, amitriptyline, acamprosate, and gabapentin) and those with anti-inflammation/anti-oxidant effect (for example, intra-tympanic dexamethasone injection plus oral melatonin) were associated with superior improvement in tinnitus severity and response rate compared to placebo/control. Oral amitriptyline were associated with the highest improvement in tinnitus severity and the fourth highest response rate. None of the investigated interventions was associated with different changes in quality of life compared to placebo/control. All the investigated treatments were associated with similar drop-out rate to placebo/control. INTERPRETATION The current NMA suggests a potential role for treatments with brain-acting effect (for example, amitriptyline, acamprosate, and gabapentin) or anti-inflammation/anti-oxidant effect (for example, intra-tympanic dexamethasone injection plus oral melatonin) as the preferable effective treatments for tinnitus without specific or treatable origin. FUNDING none.
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Key Words
- 95%CIs, 95% confidence intervals
- ACA, Acamprosate
- ALP, Alprazolam
- ALVitC, Alpha-lipoic acid plus vitamin C
- AMI, Amitriptyline
- Bet, Betahistine
- CHL, Chlorpheniramine
- CLES, Common language effect size
- CLO, Clonazepam
- Car, Carbamazepine
- ClD, Clonazepam plus deanxit
- DEX, Intra-tympanic dexamethasone injection
- DeGin, Intra-tympanic dexamethasone injection plus ginkgo biloba
- DeLid, Intra-tympanic dexamethasone injection plus lidocaine
- DeMel, Intra-tympanic dexamethasone injection plus melatonin
- GABA, gamma-Aminobutyric acid
- GRADE, Grading of Recommendations Assessment, Development and Evaluation
- GaLid, gabapentin plus intradermal lidocaine injection
- Gab, gabapentin
- Gin, ginkgo biloba
- KRG, Korean red ginseng
- MIS, Misoprostol
- MeSul, Melatonin and sulodexide
- Mel, Melatonin alone
- Met, Intra-tympanic methylprednisolone injection
- NER, Neramexane
- NMA, Network meta-analysis
- NOR, Nortriptyline
- OXC, Oxcarbazepine
- Ozone, Ozone exposure
- PAR, Paroxetine
- PIR, Piribedil
- PLA, placebo
- PRA, Pramipexole
- PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses
- PaVitE, papaverine hydrochloride plus vitamin E
- Pen, Pentoxifylline
- RCT, Randomised controlled trials
- RR, Rate ratio
- SER, Sertraline
- SMD, Standardized mean difference
- SUCRA, Surface under the cumulative ranking curve
- THI, Tinnitus handicap inventory
- TRA, Trazodone
- TRI, Postaurical subcutaneous triamcinolone injection
- VAR, Vardenafil
- VAS, Visual analogue scale
- VES, Vestipitant
- VePar, Vestipitant and paroxetine
- Zinc, Zinc supplementation
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Affiliation(s)
- Jiann-Jy Chen
- Department of Otorhinolaryngology, E-Da Cancer Hospital, Kaohsiung, Taiwan
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Bing-Syuan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Andre F. Carvalho
- IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Trevor Thompson
- Centre for Chronic Illness and Ageing, University of Greenwich, London, UK
| | - Michael Roerecke
- Institute for Mental Health Policy Research, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Dalla Lana School of Public Health (DLSPH), University of Toronto, Abbreviation:
| | - Kuan-Pin Su
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Lee Smith
- The Cambridge Center for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou branch, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shih-Pin Hsu
- Department of Neurology, E-Da hospital/School of medicine, I-Shou university, Kaohsiung, Taiwan
| | - Hung-Chang Kuo
- Department of Neurology, E-Da hospital/School of medicine, I-Shou university, Kaohsiung, Taiwan
| | - Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Corresponding author.
| | - Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Corresponding author.
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Hung CM, Chen JJ, Zeng BY, Zeng BS, Chen YW, Suen MW, Wu MK, Tseng PT. Efficacy of Different Interventions to Reduce Pre- or Perioperative Blood Transfusion Rate in Patients with Colorectal Cancer: A Network Meta-Analysis of Randomized Controlled Trials. ACTA ACUST UNITED AC 2021; 28:3214-3226. [PMID: 34436045 PMCID: PMC8395415 DOI: 10.3390/curroncol28040279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/29/2022]
Abstract
Background: The high proportion of blood transfusions before and during surgery carries unnecessary risk and results in poor prognosis in colorectal cancer patients. Different pharmacological interventions (i.e., iron supplement or recombinant erythropoietin) to reduce blood transfusion rates have shown inconclusive results. Methods: This network meta-analysis (NMA) consisted of randomized controlled trials (RCTs) comparing the efficacy of different pharmacologic interventions (i.e., iron supplementation or recombinant erythropoietin) to reduce the blood transfusion rate. NMA statistics were conducted using the frequentist model. Results: Seven RCTs (688 participants) were included in this study. The NMA demonstrated that the combination of high-dose recombinant human erythropoietin and oral iron supplements was associated with the least probability of receiving a blood transfusion [odds ratio = 0.24, 95% confidence intervals (95% CIs): 0.08 to 0.73] and best reduced the amount of blood transfused if blood transfusion was necessary (mean difference = −2.62 U, 95% CI: −3.55 to −1.70 U) when compared to the placebo/control group. None of the investigated interventions were associated with any significantly different dropout rate compared to the placebo/control group. Conclusions: The combination of high-dose recombinant human erythropoietin and oral iron supplements might be considered as a choice for reducing the rate of blood transfusion in patients with colorectal cancer. However, future large-scale RCT with long-term follow-up should be warranted to approve the long-term safety.
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Affiliation(s)
- Chao-Ming Hung
- Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan;
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 84001, Taiwan
| | - Jiann-Jy Chen
- Department of Otorhinolaryngology, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan;
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan;
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung 82445, Taiwan; (B.-Y.Z.); (B.-S.Z.)
| | - Bing-Syuan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung 82445, Taiwan; (B.-Y.Z.); (B.-S.Z.)
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan;
| | - Mein-Woei Suen
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan;
- Gender Equality Education and Research Center, Asia University, Taichung 413, Taiwan
- Department of Medical Research, Asia University Hospital, Asia University, Taichung 413, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 406040, Taiwan
| | - Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Correspondence: (M.-K.W.); (P.-T.T.); Tel.: +886-7-7317123 (M.-K.W.); +886-7-3524100 (P.-T.T.)
| | - Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung 811, Taiwan;
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan;
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
- Correspondence: (M.-K.W.); (P.-T.T.); Tel.: +886-7-7317123 (M.-K.W.); +886-7-3524100 (P.-T.T.)
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Pei SN, Liao CK, Chen YS, Tseng CH, Hung CM, Chiu CC, Hsieh MC, Tsai YF, Liao HY, Liu WC, Rau KM. A Novel Combination of Bevacizumab with Chemotherapy Improves Therapeutic Effects for Advanced Biliary Tract Cancer: A Retrospective, Observational Study. Cancers (Basel) 2021; 13:cancers13153831. [PMID: 34359732 PMCID: PMC8345065 DOI: 10.3390/cancers13153831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Biliary tract cancer (BTC) is a heterogenous collection of biliary tract cancer at different primary sites, and the prognosis of advanced BTC is dismal. Systemic chemotherapy with gemcitabine and cisplatin (GC) has been the reference regimen since 2010. How to improve therapeutic effects of GC regimen is an urgent mission at present. METHODS Bevacizumab with a reduced dosage and modified schedule (10 mg/Kg/triweekly, 1 day before GS at the first 2 cycles) was combined with standard GC for patients with advanced BTC. Tumor response was assessed using Response Evaluation Criteria in Solid Tumors version 1.1 every 2 months. Kaplan-Meier curves were estimated for time-to-treatment failure (TTF), progression-free survival (PFS) and overall survival (OS). RESULT A total of thirty cases of advanced BTC accepted this treatment, and the overall response rate (ORR) was 50.0%, and the disease control rate was 80.0% for all patients. The median TTF was 5.8 months, the median PFS was 8.4 months, and the median OS was 13.6 months. Most responses were noted at the first evaluation. Adverse effects (AEs) were mostly tolerable. CONCLUSIONS After modifying the schedule, adding bevacizumab to a traditional GC regimen could increase the ORR with a shorter time-to-response, a better PFS and OS than GC alone but without the addition of AE. This regimen can be applied to patients with advanced BTC, especially those who are with a big tumor burden and who need a rapid response.
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Affiliation(s)
- Sung-Nan Pei
- Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan; (S.-N.P.); (M.-C.H.); (Y.-F.T.); (H.-Y.L.); (W.-C.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
| | - Chun-Kai Liao
- Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
| | - Yaw-Sen Chen
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
- Division of General Surgery, Department of Surgery, E-Da Hospital, Kaohsiung 824, Taiwan
| | - Cheng-Hao Tseng
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
- Division of Gastroenterology and Hepatology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan
| | - Chao-Ming Hung
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 824, Taiwan
| | - Chong-Chi Chiu
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 824, Taiwan
| | - Meng-Che Hsieh
- Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan; (S.-N.P.); (M.-C.H.); (Y.-F.T.); (H.-Y.L.); (W.-C.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
| | - Yu-Fen Tsai
- Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan; (S.-N.P.); (M.-C.H.); (Y.-F.T.); (H.-Y.L.); (W.-C.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
| | - Hsiu-Yun Liao
- Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan; (S.-N.P.); (M.-C.H.); (Y.-F.T.); (H.-Y.L.); (W.-C.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
| | - Wei-Ching Liu
- Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan; (S.-N.P.); (M.-C.H.); (Y.-F.T.); (H.-Y.L.); (W.-C.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
| | - Kun-Ming Rau
- Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung 824, Taiwan; (S.-N.P.); (M.-C.H.); (Y.-F.T.); (H.-Y.L.); (W.-C.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan; (Y.-S.C.); (C.-H.T.); (C.-M.H.); (C.-C.C.)
- Kaohsiung Nan-Ping Cancer Prevention and Education Association, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-6150022
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Chiu CC, Ho CH, Hung CM, Chao CM, Lai CC, Chen CM, Liao KM, Wang JJ, Wu YC, Shi HY, Lee PH, Lee HM, Yeh LR, Soong TC, Chiang SR, Cheng KC. Correlation of Body Mass Index with Oncologic Outcomes in Colorectal Cancer Patients: A Large Population-Based Study. Cancers (Basel) 2021; 13:cancers13143592. [PMID: 34298805 PMCID: PMC8307410 DOI: 10.3390/cancers13143592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/07/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023] Open
Abstract
It has been acknowledged that excess body weight increases the risk of colorectal cancer (CRC); however, there is little evidence on the impact of body mass index (BMI) on CRC patients' long-term oncologic results in Asian populations. We studied the influence of BMI on overall survival (OS), disease-free survival (DFS), and CRC-specific survival rates in CRC patients from the administrative claims datasets of Taiwan using the Kaplan-Meier survival curves and the log-rank test to estimate the statistical differences among BMI groups. Underweight patients (<18.50 kg/m2) presented higher mortality (56.40%) and recurrence (5.34%) rates. Besides this, they had worse OS (aHR:1.61; 95% CI: 1.53-1.70; p-value: < 0.0001) and CRC-specific survival (aHR:1.52; 95% CI: 1.43-1.62; p-value: < 0.0001) rates compared with those of normal weight patients (18.50-24.99 kg/m2). On the contrary, CRC patients belonging to the overweight (25.00-29.99 kg/m2), class I obesity (30.00-34.99 kg/m2), and class II obesity (≥35.00 kg/m2) categories had better OS, DFS, and CRC-specific survival rates in the analysis than the patients in the normal weight category. Overweight patients consistently had the lowest mortality rate after a CRC diagnosis. The associations with being underweight may reflect a reverse causation. CRC patients should maintain a long-term healthy body weight.
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Affiliation(s)
- Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan; (C.-C.C.); (C.-M.H.); (H.-M.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan; (C.-H.H.); (Y.-C.W.)
- Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei 11695, Taiwan
- Department of Information Management, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan; (C.-C.C.); (C.-M.H.); (H.-M.L.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; (P.-H.L.); (T.-C.S.)
| | - Chien-Ming Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan;
- Department of Dental Laboratory Technology, Min-Hwei College of Health Care Management, Tainan 73657, Taiwan
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan 71004, Taiwan;
| | - Chin-Ming Chen
- Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan;
| | - Kuang-Ming Liao
- Department of Internal Medicine, Chi Mei Medical Center, Chiali 72263, Taiwan;
| | - Jhi-Joung Wang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan 71004, Taiwan;
- Department of Anesthesiology, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yu-Cih Wu
- Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan; (C.-H.H.); (Y.-C.W.)
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; (P.-H.L.); (T.-C.S.)
- Department of Surgery, E-Da Hospital, Kaohsiung 82445, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan; (C.-C.C.); (C.-M.H.); (H.-M.L.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; (P.-H.L.); (T.-C.S.)
| | - Li-Ren Yeh
- Department of Anesthesiology, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan;
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan
| | - Tien-Chou Soong
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; (P.-H.L.); (T.-C.S.)
- Weight Loss and Health Management Center, E-Da Dachang Hospital, Kaohsiung 80794, Taiwan
| | - Shyh-Ren Chiang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan;
- Department of General Education, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
| | - Kuo-Chen Cheng
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan;
- Department of Safety, Health and Environment, Chung Hwa University of Medical Technology, Tainan 71703, Taiwan
- Correspondence: ; Tel.: +886-933672369; Fax: +886-6-2828928
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Perng DS, Hung CM, Lin HY, Morgan P, Hsu YC, Wu TC, Hsieh PM, Yeh JH, Hsiao P, Lee CY, Li YC, Wang YC, Chen YS, Lin CW. Role of autophagy-related protein in the prognosis of combined hepatocellular carcinoma and cholangiocarcinoma after surgical resection. BMC Cancer 2021; 21:828. [PMID: 34273969 PMCID: PMC8286562 DOI: 10.1186/s12885-021-08553-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/21/2021] [Indexed: 01/13/2023] Open
Abstract
Background Autophagy-related proteins may predict postresection overall survival (OS) and disease-free survival (DFS) in patients with combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC). Methods We prospectively investigated how these proteins affect clinical prognosis in 40 patients who underwent hepatectomy for cHCC-CC from 2011 to 2019 at a Taiwanese hospital. Levels of autophagy-related proteins, namely LC3, Beclin-1, and p62, were immunohistochemically assessed in patient tumor and non-tumor tissues. Results We noted that LC3 expression was significantly correlated with mild clinicopathological characteristics, including macrovascular invasion, lymph node metastasis, American Joint Committee on Cancer and Barcelona Clinic Liver Cancer stages, recurrence, and mortality. Ten patient showed tumor recurrence, and 15 patients died. Postresection 5-year OS and DFS rates were 43.7 and 57.4%, respectively. Cox regression analysis showed that high intratumoral LC3 expression was significantly associated with improved OS [hazard ratio (HR; 95% confidence interval (CI)): (1.68–26.9), p = 0.007], but multiple tumors and microvascular invasion was significantly correlated with poor OS [HR (95% CI): 0.03 (0.01–0.34), p = 0.004, and 0.07 (0.01–0.46), p = 0.006, respectively]. Furthermore, high LC3 expression and cirrhosis had improved DFS [HR (95% CI): 51.3 (2.85–922), p = 0.008, and 17.9 (1.05–306), p = 0.046, respectively]. The 5-year OS and DFS rates were respectively 61.2 and 74.6% in high LC3 expression patients and 0 and 0% in those with low LC3 expression. Conclusion High LC3 expression in tumors is significantly associated with mild clinicopathological characteristics and favorable clinical prognosis in patients with cHCC-CC after resection. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08553-6.
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Affiliation(s)
- Daw-Shyong Perng
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, and School of Medicine, College of Medicine, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.,Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Hung-Yu Lin
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Paul Morgan
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, and School of Medicine, College of Medicine, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.,Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yao-Chun Hsu
- Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Tsung-Chin Wu
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, and School of Medicine, College of Medicine, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Pei-Min Hsieh
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Jen-Hao Yeh
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, and School of Medicine, College of Medicine, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.,Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Pojen Hsiao
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, and School of Medicine, College of Medicine, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Yuan Lee
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Chan Li
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, and School of Medicine, College of Medicine, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ya-Chin Wang
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, and School of Medicine, College of Medicine, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yaw-Sen Chen
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Wen Lin
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, and School of Medicine, College of Medicine, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan. .,Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. .,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. .,School of Chinese Medicine, College of Chinese Medicine, and Research Center for Traditional Chinese Medicine, China Medical University, Taichung, Taiwan.
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Chen CY, Chen WC, Hung CM, Wei YF. Chemotherapy or chemo-immunotherapy as first-line treatment for extensive-stage small-cell lung cancer - a meta-analysis. Immunotherapy 2021; 13:1165-1177. [PMID: 34261336 DOI: 10.2217/imt-2021-0135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This meta-analysis investigated the clinical benefits of chemo-immunotherapy in extensive-stage small-cell lung cancer (ES-SCLC). Seven randomized controlled trials with a total of 2862 patients were analyzed. Compared with chemotherapy alone, chemo-immunotherapy provided a better progression-free survival (PFS) with a hazard ratio (HR) of 0.81, p < 0.00001, and overall survival (OS) with a HR of 0.82, p < 0.0001; however, the incidence of treatment-related adverse effects (TRAEs) was significantly increased. Subgroup analyses showed that good performance status, cisplatin-based chemotherapy, without brain metastases at baseline and non-Asian populations were associated with greater benefits in OS from chemo-immunotherapy. Chemo-immunotherapy demonstrated better PFS and OS compared with chemotherapy alone as first line treatment in ES-SCLC, but additional TRAEs should be closely monitored.
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Affiliation(s)
- Ching-Yi Chen
- Department of Internal Medicine, Division of Chest Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Wang-Chun Chen
- Department of Pharmacy, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan.,Institute of Biotechnology & Chemical Engineering, I-Shou University, Kaohsiung, 840, Taiwan
| | - Chao-Ming Hung
- Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, 824, Taiwan
| | - Yu-Feng Wei
- Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, 824, Taiwan.,School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan.,Institute of Biotechnology & Chemical Engineering, I-Shou University, Kaohsiung, 840, Taiwan
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41
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Hung CM, Lee PH, Lee HM, Chiu CC. Gastrointestinal cytomegalovirus disease secondary to measles in an immunocompetent infant. World J Gastroenterol 2021; 27:3948-3950. [PMID: 34321857 PMCID: PMC8291027 DOI: 10.3748/wjg.v27.i25.3948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/03/2021] [Accepted: 06/16/2021] [Indexed: 02/06/2023] Open
Abstract
Yang et al reported an immunocompetent infant with gastrointestinal cytomegalovirus disease secondary to measles infection. We express our opinion about the diagnosis and treatment of this rare disease.
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Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of Surgery, E-Da Hospital, Kaohsiung 82445, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
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42
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Zeng BS, Zeng BY, Hung CM, Chen TY, Wu YC, Tu YK, Lin PY, Su KP, Stubbs B, Sun CK, Cheng YS, Li DJ, Liang CS, Hsu CW, Chen YW, Tseng PT, Chen CH. Efficacy and acceptability of different anti-fungal interventions in oropharyngeal or esophageal candidiasis in HIV co-infected adults: a pilot network meta-analysis. Expert Rev Anti Infect Ther 2021; 19:1469-1479. [PMID: 33899657 DOI: 10.1080/14787210.2021.1922078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Oropharyngeal/esophageal candidiasis are the most common opportunistic infections observed in patients with human immunodeficiency virus (HIV). While the commonly recommended treatment is fluconazole, relapse of oropharyngeal or esophageal candidiasis has been gradually increasing in recent decades.Methods: The current network meta-analysis (NMA) included randomized controlled trials (RCTs) investigating the efficacy and acceptability (i.e. drop-out rate) of different anti-fungal interventions against oropharyngeal or esophageal candidiasis in adults with HIV. All NMA procedures were conducted using the frequentist model.Results: Twenty-seven RCTs and 6277 participants were included. For oropharyngeal candidiasis, photosensitizer-based antimicrobial photodynamic therapy (aPDT) with laser irradiation plus methylene blue was associated with the highest cure rate and the lowest relapse rate among the investigated interventions [odds ratio (OR) = 6.82, 95% confidence intervals (95%CIs) = 0.19 to 244.42, p = 0.293, and OR = 0.03, 95%CIs = 0.00 to 0.77, p = 0.034, compared to fluconazole]. None of the investigated anti-fungal interventions were superior to fluconazole for esophageal candidiasis in respect of cure rates/relapse rates. All investigated anti-fungal interventions were well-accepted.Conclusions: aPDT could be the preferred strategy to manage oropharyngeal candidiasis; however the evidence for esophageal candidiasis still remained inconclusive.
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Affiliation(s)
- Bing-Syuan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Kuan-Pin Su
- Department of Psychiatry & Mind-Body Interface Laboratory (Mbi-lab), China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, I-Shou University School of Medicine for International Students, Kaohsiung, Taiwan
| | - Yu-Shian Cheng
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan.,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Chang-Hua Chen
- Program in Translational Medicine, National Chung Hsing University, Taichung City, Taiwan.,Rong Hsing Research Center For Translational Medicine, National Chung Hsing University, Taichung City, Taiwan.,Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
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Chen YS, Hsieh PM, Lin HY, Hung CM, Lo GH, Hsu YC, Lu IC, Lee CY, Wu TC, Yeh JH, Hsiao P, Li YC, Wang YC, Hsieh KC, Lin CW. Surgical resection significantly promotes the overall survival of patients with hepatocellular carcinoma: a propensity score matching analysis. BMC Gastroenterol 2021; 21:220. [PMID: 33990184 PMCID: PMC8120780 DOI: 10.1186/s12876-021-01807-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 05/06/2021] [Indexed: 12/15/2022] Open
Abstract
Background The benefits of surgical resection (SR) for various Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma (HCC) remain unclear. We investigated the risk factors of overall survival (OS) and survival benefits of SR over nonsurgical treatments in patients with HCC of various BCLC stages.
Methods Overall, 2316 HCC patients were included, and their clinicopathological data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. Results
In total, 66 (2.8%), 865 (37.4%), 575 (24.8%) and 870 (35.0%) patients had BCLC stage 0, A, B, and C disease, respectively. Furthermore, 1302 (56.2%) of all patients, and 37 (56.9%), 472 (54.6%), 313 (54.4%) and 480 (59.3%) of patients with BCLC stage 0, A, B, and C disease, respectively, died. The median follow-up duration time was 20 (range 0–96) months for the total cohort and was subdivided into 52 (8–96), 32 (1–96), 19 (0–84), and 12 (0–79) months for BCLC stages 0, A, B, and C cohorts, respectively. The risk factors for OS were (1) SR and cirrhosis; (2) SR, cirrhosis, and Child–Pugh (C–P) class; (3) SR, hepatitis B virus (HBV) infection, and C–P class; and (4) SR, HBV infection, and C–P class for the BCLC stage 0, A, B, and C cohorts, respectively. Compared to non-SR treatment, SR resulted in significantly higher survival rates in all cohorts. The 5-year OS rates for SR vs. non-SR were 44.0% versus 28.7%, 72.2% versus 42.6%, 42.6% versus 36.2, 44.6% versus 23.5%, and 41.4% versus 15.3% (all P values < 0.05) in the total and BCLC stage 0, A, B, and C cohorts, respectively. After PSM, SR resulted in significantly higher survival rates compared to non-SR treatment in various BCLC stages. Conclusions SR conferred significant survival benefits to patients with HCC of various BCLC stages and should be considered a recommended treatment for select HCC patients, especially patients with BCLC stage B and C disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-021-01807-4.
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Affiliation(s)
- Yaw-Sen Chen
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC.,Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Pei-Min Hsieh
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Hung-Yu Lin
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC.,Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Chao-Ming Hung
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC.,Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Gin-Ho Lo
- Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Yao-Chun Hsu
- Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - I-Cheng Lu
- Health Examination Center, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Chih-Yuan Lee
- Department of Surgery, National Taiwan University Hospital, Taipei, 100, Taiwan, ROC
| | - Tsung-Chin Wu
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 807, Taiwan, ROC.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Jen-Hao Yeh
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 807, Taiwan, ROC.,Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Pojen Hsiao
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 807, Taiwan, ROC.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Yu-Chan Li
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Ya-Chin Wang
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 807, Taiwan, ROC.,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Kun-Chou Hsieh
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC
| | - Chih-Wen Lin
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 807, Taiwan, ROC. .,Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC. .,Health Examination Center, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan, ROC. .,School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan, ROC. .,School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, 404, Taiwan, ROC. .,Research Center for Traditional Chinese Medicine, China Medical University Hospital, Taichung, 404, Taiwan, ROC.
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Hung CM, Lee PH, Yen CY, Huang MS, Chiu CC. Comment on: Clean Cut (adaptive, multimodal surgical infection prevention programme) for low-resource settings: a prospective quality improvement study. Br J Surg 2021; 108:e143. [PMID: 33793739 DOI: 10.1093/bjs/znaa164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Cheng-Yo Yen
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Orthopedics, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Ming-Shyan Huang
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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45
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Chiu CC, Lee PH, Chang CS, Rau KM, Hung CM. Correspondence to 'Treatment of PERItoneal disease in Stomach Cancer with cytOreductive surgery and hyperthermic intraPEritoneal chemotherapy: PERISCOPE I initial results'. Br J Surg 2021; 108:e93. [PMID: 33711116 DOI: 10.1093/bjs/znaa126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/16/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Po-Huang Lee
- Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Sung Chang
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Hematology & Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Kun-Ming Rau
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Department of Hematology & Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
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Chiu CC, Lee PH, Lee HM, Hung CM. Comment on: Use of an intraoperative wound protector to prevent surgical-site infection after pancreatoduodenectomy: randomized clinical trial. Br J Surg 2021; 108:e88. [PMID: 33711115 DOI: 10.1093/bjs/znaa084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/20/2020] [Indexed: 02/07/2023]
Abstract
Our submission is the Correspondence to the text with the title of “Use of an intraoperative wound protector to prevent surgical-site infection after pancreatoduodenectomy: randomized clinical trial”. It was published in BJS 2020; 107: 1107–1113.
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Affiliation(s)
- Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Po-Huang Lee
- Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
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Hung CM, Lee HM, Tsai KJ, Yang MC, Chiu CC. A commentary on "acute appendicitis management during the COVID-19 pandemic: A prospective cohort study from a large UK centre". Int J Surg 2021; 87:105902. [PMID: 33636359 PMCID: PMC7901278 DOI: 10.1016/j.ijsu.2021.105902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Kuen-Jang Tsai
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ming-Chieh Yang
- Department of Critical Care Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan; Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
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Chiu CC, Wang JJ, Hung CM, Lin HF, Hsien HH, Hung KW, Chiu HC, Jennifer Yeh SC, Shi HY. Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching. Brain Sci 2021; 11:brainsci11020161. [PMID: 33530541 PMCID: PMC7912561 DOI: 10.3390/brainsci11020161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/18/2021] [Accepted: 01/22/2021] [Indexed: 02/07/2023] Open
Abstract
Few papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC programs on cost and functional status simultaneously. A total of 910 patients with stroke between March 2014 and October 2018 were separated into a PAC group (at two medical centers) and a non-PAC group (at three regional hospitals and one district hospital) by using propensity score matching (1:1). A cost-illness approach was employed to identify the cost categories for analysis in this study according to various perspectives. Total direct medical cost in the per-diem-based PAC cohort was statistically lower than that in the fee-for-service-based non-PAC cohort (p < 0.001) and annual per-patient economic burden of stroke patients receiving PAC rehabilitation is approximately US $354.3 million (in 2019, NT $30.5 = US $1). Additionally, the PAC cohort had statistical improvement in functional status vis-à-vis the non-PAC cohort and total score of each functional status before rehabilitation and was also statistically significant with its total score after one-year rehabilitation training (p < 0.001). Early stroke rehabilitation is important for restoring health, confidence, and safe-care abilities in these patients. Compared to the current stroke rehabilitation system, PAC rehabilitation shortened the waiting time for transfer to the rehabilitation ward and it was indicated as an efficient policy for treatment of stroke in saving medical cost and improving functional status.
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Affiliation(s)
- Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan; (C.-C.C.); (C.-M.H.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Department of General Surgery, Chi Mei Medical Center, Liouying 73657, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan;
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan; (C.-C.C.); (C.-M.H.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Hsiu-Fen Lin
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
| | - Hong-Hsi Hsien
- Department of Internal Medicine, St. Joseph Hospital, Kaohsiung 80288, Taiwan;
| | - Kuo-Wei Hung
- Division of Neurology, Department of Internal Medicine, Yuan’s General Hospital, Kaohsiung 80249, Taiwan;
| | - Herng-Chia Chiu
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (H.-C.C.); (S.-C.J.Y.)
- Institute of Hospital Management, Tsinghua University, Beijing 100084, China
| | - Shu-Chuan Jennifer Yeh
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (H.-C.C.); (S.-C.J.Y.)
- Department of Business Management, National Sun Yat-sen University, Kaohsiung 80424, Taiwan
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (H.-C.C.); (S.-C.J.Y.)
- Department of Business Management, National Sun Yat-sen University, Kaohsiung 80424, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
- Correspondence: ; Tel.: +886-7-3211101 (ext. 2648); Fax: +886-7-3137487
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Lin CK, Chen PY, Wu YY, Wu CC, Chen HJ, Liang CL, Lee YC, Lin CW, Hung CM, Wang HK. Adjunctive Statin Therapy Reduces Mortality After Acute Hemorrhagic Stroke. Risk Manag Healthc Policy 2021; 14:177-183. [PMID: 33488130 PMCID: PMC7814233 DOI: 10.2147/rmhp.s290964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/01/2021] [Indexed: 12/19/2022] Open
Abstract
Background Statin treatment improves clinical outcomes in patients with ischemic strokes, although there is no evidence regarding the safety of statin therapy in patients with intracerebral hemorrhage (ICH). This study aimed at evaluating the effects of continuing statin treatment after ICH. Methods Data were obtained from the National Health Insurance Research Database in Taiwan. We retrospectively compared the data of patients with and without statin exposure after ICH. The outcomes of interest were recurrence of hemorrhagic stroke and mortality during a follow-up period of 10 years. Results During the 10-year follow-up period, the mortality rate was 32.73% in the statin group and 42.77% in the non-statin group. Statin therapy in patients with acute ICH with dyslipidemia can decrease mortality. Conclusion Statin therapy reduced the risk of 10-year mortality in patients who experienced acute hemorrhagic stroke.
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Affiliation(s)
- Cheng-Kai Lin
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Po-Yuan Chen
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Yu-Ying Wu
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Cheng-Chun Wu
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Han-Jung Chen
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Cheng-Loong Liang
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Yi-Che Lee
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Nephrology, E-Da Hospital, Kaohsiung, Taiwan
| | - Chi-Wei Lin
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of General Surgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Hao-Kuang Wang
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan.,Department of Neurosurgery, E-Da Cancer Hospital, Kaohsiung, Taiwan
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50
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Lin CW, Chen YS, Lo GH, Hsu YC, Hsu CC, Wu TC, Yeh JH, Hsiao P, Hsieh PM, Lin HY, Shu CW, Hung CM. Comparison of overall survival on surgical resection versus transarterial chemoembolization with or without radiofrequency ablation in intermediate stage hepatocellular carcinoma: a propensity score matching analysis. BMC Gastroenterol 2020; 20:99. [PMID: 32272898 PMCID: PMC7147026 DOI: 10.1186/s12876-020-01235-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/24/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Patients with Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) are recommended to undergo transcatheter arterial chemoembolization (TACE). However, TACE in combination with radiofrequency ablation (RFA) is not inferior to surgical resection (SR), and the benefits of surgical resection (SR) for BCLC stage B HCC remain unclear. Hence, this study aims to compare the impact of SR, TACE+RFA, and TACE on analyzing overall survival (OS) in BCLC stage B HCC. METHODS Overall, 428 HCC patients were included in BCLC stage B, and their clinical data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. RESULTS One hundred forty (32.7%) patients received SR, 57 (13.3%) received TACE+RFA, and 231 (53.9%) received TACE. The OS was significantly higher in the SR group than that in the TACE+RFA group [hazard ratio (HR): 1.78; 95% confidence incidence (CI): 1.15-2.75, p = 0.009]. The OS was significantly higher in the SR group than that in the TACE group (HR: 3.17; 95% CI: 2.31-4.36, p < 0.0001). Moreover, the OS was significantly higher in the TACE+RFA group than that in the TACE group (HR: 1.82; 95% CI: 1.21-2.74, p = 0.004). The cumulative OS rates at 1, 3 and 5 years in the SR, TACE+RFA, and TACE groups were 89.2, 69.4 and 61.2%, 86.0, 57.9 and 38.2%, and 69.5, 37.0 and 15.2%, respectively. After propensity score matching, the SR group still had a higher OS than those of the TACE+RFA and TACE groups. The TACE+RFA group had a higher OS than that of the TACE group. CONCLUSION The SR group had higher OS than the TACE+RFA and TACE groups in BCLC stage B HCC. Furthermore, the TACE+RFA group had higher OS than the TACE group.
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Affiliation(s)
- Chih-Wen Lin
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.,Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Health Examination Center, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Research Center for Traditional Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yaw-Sen Chen
- School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan.,Department of Surgery, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 82445, Taiwan
| | - Gin-Ho Lo
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.,Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan
| | - Yao-Chun Hsu
- Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan
| | - Chia-Chang Hsu
- Health Examination Center, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan
| | - Tsung-Chin Wu
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan
| | - Jen-Hao Yeh
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.,Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan
| | - Pojen Hsiao
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan
| | - Pei-Min Hsieh
- Department of Surgery, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 82445, Taiwan.,Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Hung-Yu Lin
- School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 82445, Taiwan.,Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Wen Shu
- School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- School of Medicine, College of Medicine, I-Shou University, 82445, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan. .,Department of Surgery, E-Da Hospital, I-Shou University, No. 1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 82445, Taiwan. .,Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.
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