ObjectivesThe aim of this analysis was to study the impact of marital status on inflammatory breast cancer (IBC) patients, as the prognostic impact is yet to be studied in detail.MethodsData of IBC patients from 2004 to 2010 were sorted out from the database of surveillance, epidemiology, and end results (SEER), and overall survival (OS) rates and breast cancer-specific survival (CSS) rates were compared between a group of married and unmarried patients. The comparison was performed by Kaplan–Meier method with log-rank test, and multivariate survival analysis of CSS and OS was performed using the Cox proportional hazard model.ResultsData of 1342 patients were collected from the SEER database, on an average 52% of married patients (n = 698, 52.01%) and 48% of unmarried patients (n = 644, 47.99%) for this analysis. Married patients were more likely to be more younger (aged ≤ 56) (52.44% vs. 43.94%), white ethnicity (83.24% vs. 71.58%), HoR positive (48.28% vs. 41.61%), more patients received surgery (78.51% vs. 64.60%), chemotherapy (90.69% vs. 80.12%) and radiotherapy (53.44% vs. 44.41%) compared to unmarried group, and less likely to be AJCC stage IV (26.22% vs. 35.40%) (All P ˂ 0.05). Married patients had better 5-year CSS (74.90% vs. 65.55%, P < 0.0001) and OS rates (45.43% vs. 33.11%, P < 0.0001). The multivariate analysis revealed that marital status is an independent prognostic factor, whereas the data of unmarried patients showed worse CSS (HR 1.188; 95% CI 1.033–1.367; P = 0.016) and OS rates (HR 1.245; 95% CI 1.090–1.421; P = 0.001).The subgroup analysis further revealed that the OS and CSS rates in the married group were better than the unmarried group, regardless of different AJCC stages.ConclusionMarital status was an independent prognostic indicator in IBC patients. As the study reveals, the CSS and OS rates of the married patients were better than those of the unmarried patients.Electronic supplementary materialThe online version of this article (10.1007/s10549-019-05385-8) contains supplementary material, which is available to authorized users.

Background Radial artery cannulation in young children is challenging. Here, we invented a single-operator laser-assisted ultrasound-guidance system projecting the path of the target artery on the skin surface and hypothesized that this system would improve the first-attempt success rate of radial arterial cannulation in young pediatric patients relative to traditional ultrasound guidance. Methods This single-center, prospective, parallel-group, randomized controlled study enrolled pediatric patients (n = 80, age less than two years) requiring radial artery cannulation during general anesthesia. The participants were randomized into the traditional ultrasound-guidance group or the single-operator laser-assisted ultrasound-guidance group. After inducing general anesthesia, ultrasound-guided radial artery cannulation was performed by two experienced operators. The primary outcome was the first-attempt success rate. The secondary outcomes included the procedure time to success within the first attempt, midmost rate of first attempt, first needle-tip position, and average number of adjustments. Results In total, 80 children were included in the analysis. The first-attempt success rate in the single-operator laser-assisted ultrasound-guidance group (36/40 [90%]) was significantly greater than that in the traditional ultrasound-guidance group (28/40 [70%]; absolute difference 20% (95%CI: 2.3 % to 36.6%), P = 0.025). The median procedure time to success within the first attempt was shorter in the single-operator laser-assisted ultrasound-guidance group compared with the traditional ultrasound-guidance group (31 s [27, 36 s] vs. 46 s [39, 52 s]); P &lt; 0.001). The incidence of hematoma in the single-operator laser-assisted ultrasound-guidance group (1/40, 3%) was significantly lower than that in the traditional ultrasound-guidance group (11/40, 28%; P = 0.002). Regarding the initial needle-tip position after skin puncture, median score (4 [3,4] vs. 2 [2,3]; P &lt; 0.001), position = 3, 4, or 5 (38 [95%] vs. 13 [33%]; P &lt; 0.001), and position = 4 or 5 (26 [65%] vs. 5 [13%]; P &lt; 0.001) were all in favor of single-operator laser-assisted ultrasound guidance. Conclusions Compared with traditional ultrasound guidance, the single-operator laser-assisted ultrasound-guided system is a useful add-on to the ultrasound dynamic needle-tip puncture technique. It improves the first-attempt success rate of radial artery cannulation in children younger than two years by projecting the path of the artery on the skin and provides better procedural conditions (stable ultrasound probe).

to compare the clinicopathological characteristics and survival outcomes of children and adult diagnosed with medullary thyroid carcinoma (MTC). MTC patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database from 1998 to 2016, followed by stratification into pediatric (< 20 years) or adult (≥ 20 years) groups. In total, 2,197 patients (110 pediatric and 2087 adult) with MTC were identified. Pediatric patients were more likely to have localized stage (70.0% vs. 51.6%), negative regional nodes (48.2% vs. 30.8%) and receive total/ subtotal thyroidectomy surgery (97.3% vs. 85.3%). Moreover, CSS and OS rates were significantly higher in pediatric patients (both P < 0.001). Multivariable Cox regression analysis revealed that adult patients were significantly correlated with worse CSS and OS rates [(CSS: HR 11.60, 95% CI 1.62-83.02, P = 0.015); (OS: HR 5.63, 95% CI 2.08-15.25, P = 0.001)]. Further stratified analysis indicated that pediatric group might have significant better CSS and OS for patients with more advanced stage. Patients in the pediatric group were more likely to have earlier stage. Moreover, the prognosis of pediatric MTC patients was significantly better than that in adult patients. Thyroid carcinoma is the most prevalent cancer of the endocrine system, accounting for about 1-3% of all human malignancies 1. Medullary thyroid cancer (MTC) accounts for less than 5% of all types of thyroid cancers 2,3. Compared to other types of thyroid cancer, MTC is more likely to present with more advanced and aggressive disease 4. The incidence of pediatric MTC in pediatric is extremely low, with an estimated incidence of 0.03 cases per 100,000 population per year 5,6. Due to the extremely low incidence of pediatric MTC, most clinicians, even with experienced thyroid practice, are unfamiliar with the clinicopathological characteristics and prognosis of pediatric MTC in comparison with other common thyroid cancers. Thus, it is necessary to highlight the awareness of MTC 7. In consideration of the different clinicopathological characteristics and prognosis of MTC in children and adults, it is necessary to compare and analyze between the two groups 8. Currently, the therapeutic regimen and survival outcomes of MTC have been evaluated only by a small number of studies with small sample size 9-11. Therefore, clinical decision-making concerning the optimal management of pediatric MTC is still challenging, which is generally based on extrapolation from adult MTC 9. The National Institutes of Health (NIH)' s Surveillance, Epidemiology and End Results (SEER) database, the largest and most authoritative cancer dataset in North America 12 , covers approximately 30% of the US population from several different geographic regions 13 , which provides valuable data to investigate rare malignancies 14-17. Herein, relevant data were extracted from the SEER database to determine the epidemiology, therapeutic strategies, and survival outcomes between pediatric and adult MTC patients. In the present study, w...

This study aimed to assess the benefit of postoperative adjuvant chemotherapy in stage II-III colorectal signet ring cell carcinoma (SRCC). Qualified postoperative patients were extracted from Surveillance, Epidemiology, and End Results (SEER) database from 2004 until 2015. We collected 1675 patients in the research, and 936 patients were subjected to adjuvant chemotherapy group. the proportions of married status, male, rectal cancer, grade iii/iV, AJcc stage iii and radiotherapy were higher; While, the rates of white race, ≥ 65 years old and located in cecum-transverse colon were lower in patients of chemotherapy group compared to no chemotherapy group (all P < 0.05). K-M plots revealed significantly better OS of adjuvant chemotherapy group than no chemotherapy group (P < 0.001). Meanwhile, there was no significantly different in CSS between the two groups (P = 0.93). However, after adjusting for confounding factors by multivariable Cox regression analysis, receipt of postoperative chemotherapy was still associated with better cSS and oS (cSS: hazard ratio [HR] = 0.719, 95% CI 0.612-0.844, P < 0.001) ; (OS: HR = 0.618, 95% CI 0.537-0.713, P < 0.001). Patients with stage II/III colorectal SRCC could receive survival benefit from postoperative adjuvant chemotherapy. Colorectal cancer (CRC) ranks the third of cancer-associated death, causing great health burden globally 1. The diverse pathological types of CRC have been uncovered to be having correlation with various clinical parameters and patient survival, with adenocarcinoma being most prevalent type 2,3. Signet-ring cell carcinoma (SRCC) is a relatively rare histological subtype, consisting of 0.1-2.6% of CRC patients 4,5 , defined as the abundant presence of intracellular mucin in over 50% cells according to WHO 6,7. SRCC is considered as a distinct pathological subtype in CRCs. A series of differences among colorectal SRCC, mucinous adenocarcinoma (MC) and non-mucinous adenocarcinoma (NMC) have been consistently reported. To be specific, SRCC has been reported to be associated with younger age at diagnosis, more advanced stage and poorer clinical outcomes than MC and NMC 7-9. In addition, massive lymphatic involvement, higher frequency of multiple metastatic organs and greater risks of peritoneal metastases are more commonly seen in SRCC 9. Because SRCC is relatively rare, there is a lack of consensus on therapeutic guidelines due to the difficulty in conducting large randomized controlled trials 5. At present, surgical intervention is still the optimal option for colorectal SRCC patients. Moreover, the combined application of other therapeutics has been increasing, especially chemotherapy 10. Hugen et al. have assessed the efficacy of adjuvant chemotherapy in colorectal SRCC, who further indicated the benefit of adjuvant chemotherapy in stage III SRCC patients 11. Meanwhile, by analyzing the distinct metastatic patterns of colorectal SRCC toward different sites, Tao et al. have demonstrated better survival of received chemotherapy in metastatic colorectal SR...

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