Laparoscopic versus open major liver resection for hepatocellular carcinoma: A case-matched analysis of short- and long-term outcomes
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Aoxiao He
and
Linquan Wu
Abstract
Background
The feasibility and safety of laparoscopic major hepatectomy (LMH) are still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC).
Method
Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes, and long-term oncologic outcomes were reviewed.
Results
Intraoperative blood loss (P = 0.007) was significantly lower in the LMH group. In addition, the LMH group exhibited a lower overall complication rate (P = 0.039) and shorter postoperative hospital stay (P = 0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P = 0.215) and operative cost (P = 0.860). Two laparoscopic cases were converted to open liver resection. In regard to long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P = 0.079) and overall survival (OS) (P = 0.172).
Conclusion
LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.
1 Introduction
Laparoscopic liver resection (LLR) has been increasingly utilized by surgeons since the first introduction of LLR in 1992 [1]. With the continuous development in laparoscopic devices and approaches, laparoscopic minor resections have even become standard surgical procedures for treating solitary lesions located in liver segments 2–6 [2,3,4]. However, laparoscopic major hepatectomy (LMH) has been relatively slow because LMH often correlated with a high risk of uncontrollable intraoperative bleeding, difficult procedures, and high rate of conversion. The second International Consensus Conference of Morioka recommended that LMH comprised innovative procedures in the exploration phase and could be performed only by those with experience of major open liver resections and advanced laparoscopic techniques [4]. With accumulating the development of new instruments, the introduction of novel techniques, the improvements in surgical skills, and experience of LLR, some recent studies reported that LMH and OMH had similar oncologic outcomes in patients with hepatocellular carcinoma (HCC) [5,6,7,8]. However, just a few studies described the long-term oncologic outcomes of LMH for HCC. Therefore, the present study aimed to compare the short- and long-term outcomes between LMH and OMH in patients with hepatic disease, especially those with HCC.
2 Materials and methods
2.1 Patients
Between January 2012 and December 2018, we retrospectively collected data of 26 patients who underwent LMH for HCC at The Second Affiliated Hospital of Nanchang University. In addition, a 1:3 case-matched analysis of patients (n = 78) who underwent open major hepatectomy (OMH) was also conducted based on the demographics and extent of liver resection. The study protocol was approved by the Institutional Review Board at the Second Affiliated Hospital of Nanchang University, and the informed consents were obtained from all patients. Data of the medical records including patient demographics, perioperative outcomes, and long-term oncologic follow-up were retrieved. The patients were divided into two groups according to the type of procedure: LMH group (n = 26) and OMH group (n = 78). The study was conducted in accordance with the Helsinki Declaration of 1964 and all subsequent amendments, and it was approved by the Ethics Committee of the Second Affiliated Hospital of Nanchang University in China, and all patients provided written informed consent.
2.2 Definitions
According to The Brisbane 2000 terminology, major hepatectomy (MH) was defined as resection of more than three liver segments [9,10]. Because the right posterior sectionectomy and the right anterior sectionectomy were difficult to perform by open laparoscopic hepatectomy, these procedures were also considered as MH [11]. The overall complication was defined as those that occurred within 30 days after hepatectomy. The Claviene–Dindo classification was used to grade the severity of complications [12]. Postoperative mortality was defined as death within 90 days after surgery.
2.3 Surgical procedures
The preferred type of liver resection was anatomical resection, if indicated. The selection for the type of liver resection was based on the remaining liver function, the proximity of lesions to major vascular structure, the number of lesions, and the depth of the lesion. If the hepatic reserve was expected to be enough for the deep-seated lesion, major liver resection was performed. The hepatic reserve was evaluated in terms of the computed tomographic volumetry and indocyanine green retention rate at 15 min (ICG-R15). The indication of LMH was similar to that of OMH, including the terms of the hepatic reserve, type of hepatectomy, and postoperative care [13,14]. In patients with central lesions in the suprahepatic junction adjacent to the major hepatic vein and tumors adjacent or invading to the main portal pedicle or inferior vena cava, however, laparoscopic hepatectomy was not usually considered.
It has been described in more detail elsewhere for the techniques of LMH and OMH performed at our institution [13,14]. For both anatomical right or left hepatectomy, intraoperative ultrasonography was used routinely to decide the type of hepatectomy and get the free resection margin (Figure 1a and b). The Glissonean approach was used to control the liver inflow before mobilization of the hepatic lobe (Figure 1c and d). For right posterior sectionectomy or hemihepatectomy, multiple small hepatic veins were divided, and the liver was fully mobilized from the inferior vena cava as much as possible. For left hemihepatectomy, the round ligament was first divided. Then, the left triangular ligaments and left falciform were dissected until the left hepatic vein was exposed. The left portal vein and hepatic artery were isolated and divided by Hem-o-lock clips and or Endo-GIA device, after fully mobilizing the left liver (Figure 1e and f).
Surgical techniques for LMH. (a and b) intraoperative ultrasonography is used routinely and the hepatic transection line was marked. (c and d) The Glissonean approach is used to control the liver inflow. (e and f) The left portal vein and hepatic artery are isolated and divided by Hem-o-lock clips and/or Endo-GIA device.
2.4 Postoperative care and follow-up
The same postoperative monitoring and care were given to all patients, which included routine liver function tests and blood examinations. The abdominal drainage was removed in the absence of bile leakage or peritonitis. Assessment of serum AFP levels, ultrasonography, CT, and liver function tests was required bimonthly during the first postoperative year of follow-up. Then, the aforementioned tests should be required quarterly if no recurrence was detected. Recurrence was defined as HCC, characteristic findings on follow-up CT or MRI.
2.5 Statistical analysis
SPSS 17.0 software (IBM Inc., Chicago, IL, USA) was used to process all data. Categorical variables were compared using χ 2 test or Fisher’s exact test as appropriate, and continuous parameters using Student’s t test. Kaplan–Meier estimates for DFS and OS were compared between the LMH group and the OMH group using the log-rank test. P < 0.05 was regarded as statistically significant.
3 Results
During the study period, a total of 456 consecutive patients were treated by hepatectomy. Of these patients, 26 patients underwent LMH, and a 1:3 case-matched analysis of patients (n = 78) who underwent OMH was also conducted based on the demographics and extent of liver resection.
3.1 Patients’ characteristics
Patients’ characteristics of both groups are listed in Table 1. No significant differences were found between both groups in preoperative demographic characteristics, including gender, age, BMI, Child–Pugh classification, histologic cirrhosis, comorbidities, tumor size, and the number of tumors.
Patients’ characteristics and perioperative outcomes
| LMH (n = 26) | OMH (n = 78) | p value | |
|---|---|---|---|
| Gender (M:F) | 11:15 | 33:45 | 1.000 |
| Age (years) | 56.1 ± 10.6 | 52.0 ± 12.2 | 0.698 |
| BMI (kg/m2) | 23.8 ± 3.0 | 22.8 ± 2.7 | 0.110 |
| Child–Pugh class, n (%) | |||
| A | 23 (88.5) | 70 (89.7) | 1.000 |
| B | 3 (11.5) | 8 (10.3) | |
| Histologic cirrhosis | 16 (61.5) | 45 (57.7) | 0.730 |
| Comorbidities, n (%) | |||
| Diabetes | 2 (7.6) | 7 (9.0) | 1.000 |
| Hypertension | 4 (15.4) | 8 (10.26) | 0.489 |
| Underlying hepatic disease | 11 (42.3) | 29 (37.2) | 0.642 |
| Tumor size (mm) | 75.0 ± 35.1 | 75.5 ± 38.8 | 0.378 |
| Number of tumors | 1.3 ± 0.6 | 1.4 ± 0.7 | 0.381 |
Continuous variables in the table are expressed as mean ± SD.
LMH, laparoscopic major hepatectomy; OMH, open major hepatectomy; M, male; F, female.
3.2 Surgical results
The surgical results of both groups are listed in Table 2, and no mortality during surgery was observed. Two patients (7.7%) in the laparoscopic group were converted to open procedure because of uncontrollable bleeding during parenchymal transection. A total of 55 patients (70.5%) in the OMH group and 15 patients (57.7%) in the LMH group (P = 0.227) were treated by portal triad clamping during hepatectomy. Significantly less intraoperative blood loss was found in the LMH group than in the OMH group (340.8 ± 225.2 mL vs 601.4 ± 509.4 mL, P = 0.007); however, no significant difference between the LMH group and the OMH group was found in intraoperative transfusion (26.9 vs 29.5%, P = 0.803). In addition, the operation time did not differ significantly between both groups (264.2 ± 14.1 min vs 255.4 ± 36.3 min, P = 0.215).
Operative outcomes
| LMH (n = 26) | OMH (n = 78) | P value | |
|---|---|---|---|
| Operation time (min) | 264.2 ± 14.1 | 255.4 ± 36.3 | 0.215 |
| Intraoperative blood loss (mL) | 340.8 ± 225.2 | 601.4 ± 509.4 | 0.007 |
| Intraoperative transfusion, n (%) | 7 (26.9) | 23 (29.5) | 0.803 |
| Total complication, n (%) | 4 (15.4) | 29 (37.2) | 0.039 |
| Wound infection | 2 (7.7) | 6 (7.7) | 1.000 |
| Bile leakage | 1 (3.8) | 5 (6.4) | 1.000 |
| Intraabdominal fluid collection | 1 (3.8) | 10 (12.8) | 0.357 |
| Bleeding, n (%) | 0 | 1 (1.3) | 1.000 |
| Pulmonary infection, n (%) | 0 | 5 (6.4) | 0.427 |
| Abdominal incisional hernia | 0 | 2 (2.6) | 1.000 |
| Recovery of bowel movement, days | 1.5 ± 0.5 | 3.1 ± 0.6 | 0.083 |
| Time of off-bed activities, days | 2.8 ± 0.6 | 4.9 ± 1.1 | 0.003 |
| Postoperative hospital stay, days | 11.0 ± 2.9 | 15.5 ± 5.2 | 0.024 |
| pR1, n (%) | 1 (3.8) | 7 (9.0) | 0.671 |
| pRM (mm) | 7.5 ± 35.1 | 7.1 ± 36.4 | 0.895 |
| Operative cost (RMB) | 4850.0 ± 1041.8 | 4790.3 ± 904.3 | 0.860 |
| Overall cost (RMB) | 56306.4 ± 9477.5 | 59251.9 ± 16075.6 | 0.024 |
Continuous variables in the table are expressed as mean ± SD.
LMH laparoscopic major hepatectomy, OMH open major hepatectomy, pR1 positive surgical resection margin, pRM pathological resection margin.
P < 0.05 was considered statistically significant and was shown in bold.
A total 18 patients (69.2%) in the LMH group and 54 patients (69.2%) in the OMH underwent right hepatectomy. Pathologic examination of free resection margin was similar between both groups (96.2 vs 91.0%, P = 0.671).
3.3 Postoperative outcomes and cost
Postoperative results of both groups are listed in Table 2. There were one laparoscopy patient (3.8%) and five (6.4%) patients undergoing open surgery with hepatectomy-related complications after surgery (P = 1.000). Overall complications were significantly lower in the LMH group compared to the OMH group (15.4 vs 37.2%, P = 0.039). There was no perioperative mortality between both groups. Although no significant difference was found in the recovery of the bowel movement (1.5 ± 0.5 days vs 3.1 ± 0.6 days, P = 0.083) between both groups, duration of off-bed activities (2.8 ± 0.6 days vs 4.9 ± 1.1 days, P = 0.003) and postoperative hospital stay (11.0 ± 2.9 days vs 15.5 ± 5.2 days, P = 0.024) was significantly shorter in the LMH group compared to the OMH group. Both the surgical and overall costs were collected. Interesting, we found that although no significant difference was found in surgical cost between both groups (4850.0 ± 1041.8 RMB vs 4790.3 ± 904.3 RMB, P = 0.860), the overall cost of the LMH group was significantly lower than the OMH group (56306.4 ± 9477.5 RMB vs 59251.9 ± 16075.6 RMB, P = 0.024).
3.4 Long-term survival outcomes
The follow-up was 33.3 ± 15.6 months in the LMH group and 31.4 ± 15.7 months in the OLH group, and no significant difference was found between both groups (P = 0.752). The median OS of LMH and OMH groups was 60.0 months (95% CI, 50.3–69.7 months) and 60.0 months, respectively (95% CI, 47.6–72.4 months; Figure 2a). The median DFS of LMH and OMH groups was 63.0 months (95% confidence interval [CI] 31.8–94.1 months) and 36.0 months (95% CI, 29.7–42.3 months), respectively (Figure 2b). No significant difference in OS (P = 0.172) and DFS (P = 0.079) was found between both groups.
Weighted Kaplan–Meier plot for DFS and OS for LMH versus OMH. (a) Median DFS of LMH and OMH groups was 63.0 and 36.0 months (P = 0.079), respectively. (b) Median OS of LMH and OMH groups was 60.0 and 60.0 months (P = 0.172), respectively.
4 Discussion
With the continuous development in laparoscopic devices and approaches, laparoscopic minor liver resections have even become standard surgical procedures for treating solitary lesions located in liver segments 2–6 [2,3,4]. Due to the long learning curve for LLR, it is necessary to consider the expertise of the surgeon for safe laparoscopic minor resection [15,16]. Recently, in some highly specialized centers, LMH can be performed as effectively and safely as OMH [3]. LMH even was not inferior to OMH in terms of resection margin, postoperative complications, operative mortality, and long-term outcomes stated by the Second International Consensus Conference held in Morioka; in addition, LLR was superior in terms of shorter hospital stay [4].
As presented in Table 3, we have summarized all comparative studies of major LLR vs major OLR [4,5,6,7,8,17,18,19,20,21,22,23]. The negative margins and oncologic integrity of the procedure should be obtained, when major LLR is performed for cancer. No difference in the resection margin was found in the comparative studies of major LLR vs major OLR, although the tumor size of major LLR was large than that of major OLR in the studies by Guro et al. [8], Goumard et al. [17], Komatsu et al. [18], and Tarantino et al. [20]. In the present case-matched study, the negative margin of major LLR was similar to major OLR. In addition, the R0 resection rate of the LMH group was 96.2%. Recently, some meta-analyses of retrospective studies also observed that no significant difference was found between major LLR and major OLR in the resection margin for HCC patients [24,25]. To better learn major LLR for HCC patients, long-term survival rate should also be obtained. As shown in Table 3, data of 5-year over survival (OS) and disease-free survival (DFS) were obtained from three studies including the data of our study. Although the laparoscopic group has a longer OS compared to open group, no significant difference was found between both groups with regard to OS and DFS. In addition, Wang et al. [26] conducted a meta-analysis, which compared short- and long-term outcomes of major LLR with those of major OLR. The results of this meta-analysis showed that major LLR had advantages in intraoperative blood loss, postoperative hospital stay, and postoperative morbidity. Therefore, we can conclude that major LLR may be as oncological safety as major OLR. Because the aforementioned data come from observational clinical studies, however, additional randomized controlled trials are required to provide convincing evidence in the future.
Main characteristics of the comparative studies of major LLR vs major OLR
| Authors | Type of surgery | No. of patients | Tumor size (mm) | Number of tumors | Resection margins (mm) | Operation time (min) | Intraoperative blood loss (mL) | No. transfusions | Total complications | Postoperative hospital stay (days) | Hospital death | OS | DFS |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Chen et al. [5] | LMH | 126 | 64 (14–130) | 112/14 | NA | 240 (75–590) | 200 (20–2500) | 6 (4.8%) | 28 (22.2%) | 6 (3–21) | 0 (0%) | NA | NA |
| OMH | 133 | 67 (16–240) | 110/23 | NA | 230 (100–495) | 400 (50–2,000) | 22 (16.5%) | 36 (27.1%) | 8 (4–46) | 1 (0.9%) | NA | NA | |
| Cho et al. [6] | LRPS | 24 | 37 ± 18 | NA | 3.0 ± 5.8 | 567.4 ± 212.4 | NA | NA | 2 (8.3%) | 10.6 ± 4.8 | NA | 79.1% (5 years) | 42.2% (5 years) |
| ORPS | 19 | 48 ± 25 | NA | 7.0 ± 5.0 | 316.1 ± 63.0 | NA | NA | 4 (21.1%) | 11.1 ± 3.2 | NA | 77.7% | 51.5% | |
| Cho et al. [7] | LCH | 20 | 26 (6–140) | NA | 7 (0.1–40) | 388 (246–661) | 350 (100–1,300) | 2 (10%) | 6 (30%) | 8 (5–24) | 6 (30%) | NA | NA |
| OCH | 20 | 27 (10–82) | NA | 6.5 (0.1–23) | 268 (98–412) | 400 (50–3,300) | 1 (5%) | 4 (20%) | 10 (5–24) | 4 (20%) | NA | NA | |
| Goumard et al. [8] | LRH | 16 | 39 (2–85) | 1.5 (1–3) | 13.5 (0–50) | 360 (240–450) | 150 (100–700) | 1 (6.3%) | 4 (25%) | 7 (5–11) | 0 (0%) | 67.1 % (3-year) | NA |
| ORH | 16 | 62 (0–250) | 1.5 (1–3) | 6.5 (0–60) | 300 (240–390) | 100 (100–800) | 0 (0%) | 8 (50%) | 12 (7–25) | 1 (6.3%) | NA | NA | |
| Guro et al. [17] | LMH | 67 | 41 ± 24 | NA | 2 (2.4%) | 416.6 ± 166.9 | 1543.3 ± 2641.8 | 29 (34.9%) | 17 (20.5%) | 11.3 ± 8.3 | 1 (1.5%) | 77.3% (5 years) | 50.8% (5 years) |
| OMH | 110 | 63 ± 38 | NA | 6 (5.4%) | 332.5 ± 105.4 | 1248.1 ± 1402.8 | 45 (40.5%) | 43 (38.7%) | 18 ± 21.4 | 3 (2.7%) | 60.2% | 40.1% | |
| Komatsu et al. [18] | LMH | 38 | 47.5 (23–180) | 19/19 | 6 (15.8%) | 365 (180–600) | 100 (20–900) | 2 (5.2%) | 12 (31.6%) | 7.5 (3–51) | NA | 73.4 % (3 years) | 50.3 % (3 years) |
| OMH | 38 | 85.0 (20–180) | 16/22 | 6 (15.8%) | 300 (210–425) | 80 (20–800) | 1 (2.6%) | 23 (60.5%) | 10.0 (5–53) | NA | 69.2% | 29.7% | |
| Rhu et al. [19] | LRPS | 53 | 31 ± 18 | 47/6 | 13 ± 10 | 381 ± 149 | NA | 7 (13.2) | 5 (9.4%) | 8.9 ± 3.6 | 0 | NA | NA |
| ORPS | 97 | 31 ± 17 | 89/8 | 12 ± 9 | 220 ± 91 | NA | 2 (2.1) | 8 (8.3%) | 10.2 ± 3.6 | 1 (1%) | NA | NA | |
| Tarantino et al. [20] | LRPS | 13 | 27 ± 9 | 1.0 ± 0.2 | 10 ± 3 | 234 ± 57 | 125 ± 80 | NA | 2 (15.3%) | 5.7 ± 3 | NA | NA | NA |
| ORPS | 51 | 37 ± 23 | 1.0 ± 0.2 | 10 ± 2 | 216 ± 73 | 208 ± 263 | NA | 27 (52.9%) | 10.7 ± 5 | NA | NA | NA | |
| Yoon et al. [21] | LRH | 33 | 33.1 ± 16.5 | 1.1 ± 0.2 | 26 ± 21 | 297 ± 113 | 125.5 ± 229 | 0 (0) | 1 (3.03%) | 9.97 ± 3.02 | NA | 85.1% (2 years) | 100% (2 years) |
| ORH | 33 | 29.6 ± 15 | 1.1 ± 0.2 | 20 ± 15 | 176 ± 60 | 132 ± 178 | 0 (0) | 7 (21.21%) | 13.94 ± 3.37 | NA | 83.9% | 88.8% | |
| Zhang et al. [22] | LRH | 35 | 67 ± 42 | NA | 35/0 | 309 ± 108 | 293 ± 82.5 | NA | 0 | 9 ± 2 | NA | NA | NA |
| ORH | 42 | 59 ± 30 | NA | 42/0 | 223 ± 110 | 433 ± 105.5 | NA | 21 (50%) | 15 ± 3 | NA | NA | NA | |
| Zhang et al. [23] | LLH | 20 | 67 ± 42 | NA | 20/0 | 143 ± 35.6 | 180 ± 20.5 | NA | 0 | 7 ± 1 | NA | NA | NA |
| OLH | 25 | 59 ± 30 | NA | 25/0 | 137 ± 29.8 | 350 ± 45.3 | NA | 10 (40%) | 12 ± 2 | NA | NA | NA | |
| Our results | LMH | 26 | 75 ± 35 | 1.3 ± 0.6 | 7.5 ± 35.1 | 264.2 ± 14.1 | 340.8 ± 225.2 | 7 (26.9%) | 4 (15.4%) | 11.0 ± 2.9 | 0 (0%) | 53.7% (5 years) | 52.4% (5 years) |
| OMH | 78 | 76 ± 39 | 1.4 ± 0.7 | 7.1 ± 36.4 | 255.4 ± 36.3 | 601.4 ± 509.4 | 23 (29.5%) | 29 (37.2%) | 15.5 ± 5.2 | 0 (0%) | 47.6% | 21.4% |
Continuous variables in the table are expressed as mean ± SD or median(range) unless otherwise specified.
LCH, laparoscopic central hepatectomy; LRPS, laparoscopic right posterior sectionectomy; LRH, laparoscopic right hepatectomy; LLH, laparoscopic left hemihepatectomy.
Statistically significant results are shown in bold.
P < 0.05 was considered statistically significant and was shown in bold.
With regard to the data on perioperative outcomes, major LLR was associated with favorable intraoperative blood loss, total postoperative complications, and postoperative hospital stay in the summarized comparative studies. However, the operation time of major LLR was significantly longer than major OLR in most of the retrospective studies [4,5,6,7,8,17,18,19,21,22]. Recently, the Japanese National Clinical Database showed that major LLR was associated with less blood loss, a lower complication rate, and shorter hospital stay compared with major OLR [27]. Regarding short-term outcomes in the present study, the average operation time of major LLR group was longer than OLR group. However, major LLR group has a significantly lower intraoperative blood loss and postoperative complication rate and shorter postoperative hospital stay. This indicates that although major LLR is technically more difficult than OLR, major LLR is similar to major OLR in short-term outcomes. Furthermore, owing to its minimal invasiveness, major LLR facilitates earlier patient recovery. Interestingly, our results showed that although no significant difference was found in surgical cost between both groups, the overall cost of the LMH group was significantly lower than the OMH group, which might be related to fast recovery.
To the best of our knowledge, the present report was the first study that summarized the long-term survival rate of major LLR in patients with HCC. However, there were many limitations in this study. First, this was a retrospective study, which may introduce bias. Second, although there was no difference in the resection margin between the two groups, we preferred major OLR in patients with HCC close to the major Glisson pedicle or the inferior vena cava.
5 Conclusion
In conclusion, major LLR of HCC is feasible and safe with favorable short- and long-term outcomes, when performed in experienced centers.
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Funding information: The present study was supported by grants from the Department of Education Project of Jiangxi Province, China (Grant No. GJJ180083), the Science and Technology Project of Health Commission of Jiangxi Province, China (Grant No. 20204266), and the Traditional Chinese Medicine Science and Technology Project of Jiangxi Province, China (Grant No. 2019A015).
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Author contributions: Aoxiao He, Zhihao Huang, Long Peng and Linquan Wu: conceived and designed the study; collected, assembled, analyzed, and interpreted the data; and wrote the manuscript. Qian Feng and Hongcheng Lu: conceived and designed the study and performed the analysis with constructive discussions. Rongguiyi Zhang and Jiakun Wang: statistical analysis and reviewed the manuscript.
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Conflict of interest: The authors declare that they have no competing interests.
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Data availability statement: The datasets used or analyzed in this study are available from the corresponding author on reasonable request.
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[20] Tarantino G, Magistri P, Serra V, Berardi G, Assirati G, Ballarin R, et al. Laparoscopic liver resection of right posterior segments for hepatocellular carcinoma on cirrhosis. J Laparoendosc Adv Surg Tech A. 2017;27:559–63.10.1089/lap.2016.0506Search in Google Scholar PubMed
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© 2021 Aoxiao He et al., published by De Gruyter
This work is licensed under the Creative Commons Attribution 4.0 International License.
Articles in the same Issue
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- Expression and clinical significance of CMTM1 in hepatocellular carcinoma
- miR-142-5p promotes cervical cancer progression by targeting LMX1A through Wnt/β-catenin pathway
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- Intestinal fatty acid-binding protein as a biomarker for the diagnosis of strangulated intestinal obstruction: A meta-analysis
- miR-128-3p inhibits apoptosis and inflammation in LPS-induced sepsis by targeting TGFBR2
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- Fertility problems in males carrying an inversion of chromosome 10
- Acute myeloid leukemia with leukemic pleural effusion and high levels of pleural adenosine deaminase: A case report and review of literature
- Metastatic renal Ewing’s sarcoma in adult woman: Case report and review of the literature
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- Judicious use of low-dosage corticosteroids for non-severe COVID-19: A case report
- Adult-onset citrullinaemia type II with liver cirrhosis: A rare cause of hyperammonaemia
- Clinicopathologic features of Good’s syndrome: Two cases and literature review
- Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
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- Ratios between circulating myeloid cells and lymphocytes are associated with mortality in severe COVID-19 patients
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- Clinical features of hypertensive patients with COVID-19 compared with a normotensive group: Single-center experience in China
- Surgical myocardial revascularization outcomes in Kawasaki disease: systematic review and meta-analysis
- Decreased chromobox homologue 7 expression is associated with epithelial–mesenchymal transition and poor prognosis in cervical cancer
- FGF16 regulated by miR-520b enhances the cell proliferation of lung cancer
- Platelet-rich fibrin: Basics of biological actions and protocol modifications
- Accurate diagnosis of prostate cancer using logistic regression
- miR-377 inhibition enhances the survival of trophoblast cells via upregulation of FNDC5 in gestational diabetes mellitus
- Prognostic significance of TRIM28 expression in patients with breast carcinoma
- Integrative bioinformatics analysis of KPNA2 in six major human cancers
- Exosomal-mediated transfer of OIP5-AS1 enhanced cell chemoresistance to trastuzumab in breast cancer via up-regulating HMGB3 by sponging miR-381-3p
- A four-lncRNA signature for predicting prognosis of recurrence patients with gastric cancer
- Knockdown of circ_0003204 alleviates oxidative low-density lipoprotein-induced human umbilical vein endothelial cells injury: Circulating RNAs could explain atherosclerosis disease progression
- Propofol postpones colorectal cancer development through circ_0026344/miR-645/Akt/mTOR signal pathway
- Knockdown of lncRNA TapSAKI alleviates LPS-induced injury in HK-2 cells through the miR-205/IRF3 pathway
- COVID-19 severity in relation to sociodemographics and vitamin D use
- Clinical analysis of 11 cases of nocardiosis
- Cis-regulatory elements in conserved non-coding sequences of nuclear receptor genes indicate for crosstalk between endocrine systems
- Four long noncoding RNAs act as biomarkers in lung adenocarcinoma
- Real-world evidence of cytomegalovirus reactivation in non-Hodgkin lymphomas treated with bendamustine-containing regimens
- Relation between IL-8 level and obstructive sleep apnea syndrome
- circAGFG1 sponges miR-28-5p to promote non-small-cell lung cancer progression through modulating HIF-1α level
- Nomogram prediction model for renal anaemia in IgA nephropathy patients
- Effect of antibiotic use on the efficacy of nivolumab in the treatment of advanced/metastatic non-small cell lung cancer: A meta-analysis
- NDRG2 inhibition facilitates angiogenesis of hepatocellular carcinoma
- A nomogram for predicting metabolic steatohepatitis: The combination of NAMPT, RALGDS, GADD45B, FOSL2, RTP3, and RASD1
- Clinical and prognostic features of MMP-2 and VEGF in AEG patients
- The value of miR-510 in the prognosis and development of colon cancer
- Functional implications of PABPC1 in the development of ovarian cancer
- Prognostic value of preoperative inflammation-based predictors in patients with bladder carcinoma after radical cystectomy
- Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis
- Prediction of improvement after anterior cruciate ligament reconstruction
- Effluent Osteopontin levels reflect the peritoneal solute transport rate
- circ_0038467 promotes PM2.5-induced bronchial epithelial cell dysfunction
- Significance of miR-141 and miR-340 in cervical squamous cell carcinoma
- Association between hair cortisol concentration and metabolic syndrome
- Microvessel density as a prognostic indicator of prostate cancer: A systematic review and meta-analysis
- Characteristics of BCR–ABL gene variants in patients of chronic myeloid leukemia
- Knee alterations in rheumatoid arthritis: Comparison of US and MRI
- Long non-coding RNA TUG1 aggravates cerebral ischemia and reperfusion injury by sponging miR-493-3p/miR-410-3p
- lncRNA MALAT1 regulated ATAD2 to facilitate retinoblastoma progression via miR-655-3p
- Development and validation of a nomogram for predicting severity in patients with hemorrhagic fever with renal syndrome: A retrospective study
- Analysis of COVID-19 outbreak origin in China in 2019 using differentiation method for unusual epidemiological events
- Laparoscopic versus open major liver resection for hepatocellular carcinoma: A case-matched analysis of short- and long-term outcomes
- Travelers’ vaccines and their adverse events in Nara, Japan
- Association between Tfh and PGA in children with Henoch–Schönlein purpura
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- Circular RNA VANGL1 knockdown suppressed viability, promoted apoptosis, and increased doxorubicin sensitivity through targeting miR-145-5p to regulate SOX4 in bladder cancer cells
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- Algorithm of rational approach to reconstruction in Fournier’s disease
- A meta-analysis of exosome in the treatment of spinal cord injury
- Src-1 and SP2 promote the proliferation and epithelial–mesenchymal transition of nasopharyngeal carcinoma
- Dexmedetomidine may decrease the bupivacaine toxicity to heart
- Hypoxia stimulates the migration and invasion of osteosarcoma via up-regulating the NUSAP1 expression
- Long noncoding RNA XIST knockdown relieves the injury of microglia cells after spinal cord injury by sponging miR-219-5p
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- Comparison of single- and triple-port VATS for lung cancer: A meta-analysis
- Fluorescent light energy modulates healing in skin grafted mouse model
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- Primary intradural extramedullary extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) of the thoracolumbar spine: A case report and literature review
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- High quality of 58-month life in lung cancer patient with brain metastases sequentially treated with gefitinib and osimertinib
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- Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part I
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Articles in the same Issue
- Research Articles
- Identification of ZG16B as a prognostic biomarker in breast cancer
- Behçet’s disease with latent Mycobacterium tuberculosis infection
- Erratum
- Erratum to “Suffering from Cerebral Small Vessel Disease with and without Metabolic Syndrome”
- Research Articles
- GPR37 promotes the malignancy of lung adenocarcinoma via TGF-β/Smad pathway
- Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
- Additional baricitinib loading dose improves clinical outcome in COVID-19
- The co-treatment of rosuvastatin with dapagliflozin synergistically inhibited apoptosis via activating the PI3K/AKt/mTOR signaling pathway in myocardial ischemia/reperfusion injury rats
- SLC12A8 plays a key role in bladder cancer progression and EMT
- LncRNA ATXN8OS enhances tamoxifen resistance in breast cancer
- Case Report
- Serratia marcescens as a cause of unfavorable outcome in the twin pregnancy
- Spleno-adrenal fusion mimicking an adrenal metastasis of a renal cell carcinoma: A case report and embryological background
- Research Articles
- TRIM25 contributes to the malignancy of acute myeloid leukemia and is negatively regulated by microRNA-137
- CircRNA circ_0004370 promotes cell proliferation, migration, and invasion and inhibits cell apoptosis of esophageal cancer via miR-1301-3p/COL1A1 axis
- LncRNA XIST regulates atherosclerosis progression in ox-LDL-induced HUVECs
- Potential role of IFN-γ and IL-5 in sepsis prediction of preterm neonates
- Rapid Communication
- COVID-19 vaccine: Call for employees in international transportation industries and international travelers as the first priority in global distribution
- Case Report
- Rare squamous cell carcinoma of the kidney with concurrent xanthogranulomatous pyelonephritis: A case report and review of the literature
- An infertile female delivered a baby after removal of primary renal carcinoid tumor
- Research Articles
- Hypertension, BMI, and cardiovascular and cerebrovascular diseases
- Case Report
- Coexistence of bilateral macular edema and pale optic disc in the patient with Cohen syndrome
- Research Articles
- Correlation between kinematic sagittal parameters of the cervical lordosis or head posture and disc degeneration in patients with posterior neck pain
- Review Articles
- Hepatoid adenocarcinoma of the lung: An analysis of the Surveillance, Epidemiology, and End Results (SEER) database
- Research Articles
- Thermography in the diagnosis of carpal tunnel syndrome
- Pemetrexed-based first-line chemotherapy had particularly prominent objective response rate for advanced NSCLC: A network meta-analysis
- Comparison of single and double autologous stem cell transplantation in multiple myeloma patients
- The influence of smoking in minimally invasive spinal fusion surgery
- Impact of body mass index on left atrial dimension in HOCM patients
- Expression and clinical significance of CMTM1 in hepatocellular carcinoma
- miR-142-5p promotes cervical cancer progression by targeting LMX1A through Wnt/β-catenin pathway
- Comparison of multiple flatfoot indicators in 5–8-year-old children
- Early MRI imaging and follow-up study in cerebral amyloid angiopathy
- Intestinal fatty acid-binding protein as a biomarker for the diagnosis of strangulated intestinal obstruction: A meta-analysis
- miR-128-3p inhibits apoptosis and inflammation in LPS-induced sepsis by targeting TGFBR2
- Dynamic perfusion CT – A promising tool to diagnose pancreatic ductal adenocarcinoma
- Biomechanical evaluation of self-cinching stitch techniques in rotator cuff repair: The single-loop and double-loop knot stitches
- Review Articles
- The ambiguous role of mannose-binding lectin (MBL) in human immunity
- Case Report
- Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report
- Fertility problems in males carrying an inversion of chromosome 10
- Acute myeloid leukemia with leukemic pleural effusion and high levels of pleural adenosine deaminase: A case report and review of literature
- Metastatic renal Ewing’s sarcoma in adult woman: Case report and review of the literature
- Burkitt-like lymphoma with 11q aberration in a patient with AIDS and a patient without AIDS: Two cases reports and literature review
- Skull hemophilia pseudotumor: A case report
- Judicious use of low-dosage corticosteroids for non-severe COVID-19: A case report
- Adult-onset citrullinaemia type II with liver cirrhosis: A rare cause of hyperammonaemia
- Clinicopathologic features of Good’s syndrome: Two cases and literature review
- Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
- Research Articles
- Effects of hydroxyethyl starch and gelatin on the risk of acute kidney injury following orthotopic liver transplantation: A multicenter retrospective comparative clinical study
- Significance of nucleic acid positive anal swab in COVID-19 patients
- circAPLP2 promotes colorectal cancer progression by upregulating HELLS by targeting miR-335-5p
- Ratios between circulating myeloid cells and lymphocytes are associated with mortality in severe COVID-19 patients
- Risk factors of left atrial appendage thrombus in patients with non-valvular atrial fibrillation
- Clinical features of hypertensive patients with COVID-19 compared with a normotensive group: Single-center experience in China
- Surgical myocardial revascularization outcomes in Kawasaki disease: systematic review and meta-analysis
- Decreased chromobox homologue 7 expression is associated with epithelial–mesenchymal transition and poor prognosis in cervical cancer
- FGF16 regulated by miR-520b enhances the cell proliferation of lung cancer
- Platelet-rich fibrin: Basics of biological actions and protocol modifications
- Accurate diagnosis of prostate cancer using logistic regression
- miR-377 inhibition enhances the survival of trophoblast cells via upregulation of FNDC5 in gestational diabetes mellitus
- Prognostic significance of TRIM28 expression in patients with breast carcinoma
- Integrative bioinformatics analysis of KPNA2 in six major human cancers
- Exosomal-mediated transfer of OIP5-AS1 enhanced cell chemoresistance to trastuzumab in breast cancer via up-regulating HMGB3 by sponging miR-381-3p
- A four-lncRNA signature for predicting prognosis of recurrence patients with gastric cancer
- Knockdown of circ_0003204 alleviates oxidative low-density lipoprotein-induced human umbilical vein endothelial cells injury: Circulating RNAs could explain atherosclerosis disease progression
- Propofol postpones colorectal cancer development through circ_0026344/miR-645/Akt/mTOR signal pathway
- Knockdown of lncRNA TapSAKI alleviates LPS-induced injury in HK-2 cells through the miR-205/IRF3 pathway
- COVID-19 severity in relation to sociodemographics and vitamin D use
- Clinical analysis of 11 cases of nocardiosis
- Cis-regulatory elements in conserved non-coding sequences of nuclear receptor genes indicate for crosstalk between endocrine systems
- Four long noncoding RNAs act as biomarkers in lung adenocarcinoma
- Real-world evidence of cytomegalovirus reactivation in non-Hodgkin lymphomas treated with bendamustine-containing regimens
- Relation between IL-8 level and obstructive sleep apnea syndrome
- circAGFG1 sponges miR-28-5p to promote non-small-cell lung cancer progression through modulating HIF-1α level
- Nomogram prediction model for renal anaemia in IgA nephropathy patients
- Effect of antibiotic use on the efficacy of nivolumab in the treatment of advanced/metastatic non-small cell lung cancer: A meta-analysis
- NDRG2 inhibition facilitates angiogenesis of hepatocellular carcinoma
- A nomogram for predicting metabolic steatohepatitis: The combination of NAMPT, RALGDS, GADD45B, FOSL2, RTP3, and RASD1
- Clinical and prognostic features of MMP-2 and VEGF in AEG patients
- The value of miR-510 in the prognosis and development of colon cancer
- Functional implications of PABPC1 in the development of ovarian cancer
- Prognostic value of preoperative inflammation-based predictors in patients with bladder carcinoma after radical cystectomy
- Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis
- Prediction of improvement after anterior cruciate ligament reconstruction
- Effluent Osteopontin levels reflect the peritoneal solute transport rate
- circ_0038467 promotes PM2.5-induced bronchial epithelial cell dysfunction
- Significance of miR-141 and miR-340 in cervical squamous cell carcinoma
- Association between hair cortisol concentration and metabolic syndrome
- Microvessel density as a prognostic indicator of prostate cancer: A systematic review and meta-analysis
- Characteristics of BCR–ABL gene variants in patients of chronic myeloid leukemia
- Knee alterations in rheumatoid arthritis: Comparison of US and MRI
- Long non-coding RNA TUG1 aggravates cerebral ischemia and reperfusion injury by sponging miR-493-3p/miR-410-3p
- lncRNA MALAT1 regulated ATAD2 to facilitate retinoblastoma progression via miR-655-3p
- Development and validation of a nomogram for predicting severity in patients with hemorrhagic fever with renal syndrome: A retrospective study
- Analysis of COVID-19 outbreak origin in China in 2019 using differentiation method for unusual epidemiological events
- Laparoscopic versus open major liver resection for hepatocellular carcinoma: A case-matched analysis of short- and long-term outcomes
- Travelers’ vaccines and their adverse events in Nara, Japan
- Association between Tfh and PGA in children with Henoch–Schönlein purpura
- Can exchange transfusion be replaced by double-LED phototherapy?
- circ_0005962 functions as an oncogene to aggravate NSCLC progression
- Circular RNA VANGL1 knockdown suppressed viability, promoted apoptosis, and increased doxorubicin sensitivity through targeting miR-145-5p to regulate SOX4 in bladder cancer cells
- Serum intact fibroblast growth factor 23 in healthy paediatric population
- Algorithm of rational approach to reconstruction in Fournier’s disease
- A meta-analysis of exosome in the treatment of spinal cord injury
- Src-1 and SP2 promote the proliferation and epithelial–mesenchymal transition of nasopharyngeal carcinoma
- Dexmedetomidine may decrease the bupivacaine toxicity to heart
- Hypoxia stimulates the migration and invasion of osteosarcoma via up-regulating the NUSAP1 expression
- Long noncoding RNA XIST knockdown relieves the injury of microglia cells after spinal cord injury by sponging miR-219-5p
- External fixation via the anterior inferior iliac spine for proximal femoral fractures in young patients
- miR-128-3p reduced acute lung injury induced by sepsis via targeting PEL12
- HAGLR promotes neuron differentiation through the miR-130a-3p-MeCP2 axis
- Phosphoglycerate mutase 2 is elevated in serum of patients with heart failure and correlates with the disease severity and patient’s prognosis
- Cell population data in identifying active tuberculosis and community-acquired pneumonia
- Prognostic value of microRNA-4521 in non-small cell lung cancer and its regulatory effect on tumor progression
- Mean platelet volume and red blood cell distribution width is associated with prognosis in premature neonates with sepsis
- 3D-printed porous scaffold promotes osteogenic differentiation of hADMSCs
- Association of gene polymorphisms with women urinary incontinence
- Influence of COVID-19 pandemic on stress levels of urologic patients
- miR-496 inhibits proliferation via LYN and AKT pathway in gastric cancer
- miR-519d downregulates LEP expression to inhibit preeclampsia development
- Comparison of single- and triple-port VATS for lung cancer: A meta-analysis
- Fluorescent light energy modulates healing in skin grafted mouse model
- Silencing CDK6-AS1 inhibits LPS-induced inflammatory damage in HK-2 cells
- Predictive effect of DCE-MRI and DWI in brain metastases from NSCLC
- Severe postoperative hyperbilirubinemia in congenital heart disease
- Baicalin improves podocyte injury in rats with diabetic nephropathy by inhibiting PI3K/Akt/mTOR signaling pathway
- Clinical factors predicting ureteral stent failure in patients with external ureteral compression
- Novel H2S donor proglumide-ADT-OH protects HUVECs from ox-LDL-induced injury through NF-κB and JAK/SATA pathway
- Triple-Endobutton and clavicular hook: A propensity score matching analysis
- Long noncoding RNA MIAT inhibits the progression of diabetic nephropathy and the activation of NF-κB pathway in high glucose-treated renal tubular epithelial cells by the miR-182-5p/GPRC5A axis
- Serum exosomal miR-122-5p, GAS, and PGR in the non-invasive diagnosis of CAG
- miR-513b-5p inhibits the proliferation and promotes apoptosis of retinoblastoma cells by targeting TRIB1
- Fer exacerbates renal fibrosis and can be targeted by miR-29c-3p
- The diagnostic and prognostic value of miR-92a in gastric cancer: A systematic review and meta-analysis
- Prognostic value of α2δ1 in hypopharyngeal carcinoma: A retrospective study
- No significant benefit of moderate-dose vitamin C on severe COVID-19 cases
- circ_0000467 promotes the proliferation, metastasis, and angiogenesis in colorectal cancer cells through regulating KLF12 expression by sponging miR-4766-5p
- Downregulation of RAB7 and Caveolin-1 increases MMP-2 activity in renal tubular epithelial cells under hypoxic conditions
- Educational program for orthopedic surgeons’ influences for osteoporosis
- Expression and function analysis of CRABP2 and FABP5, and their ratio in esophageal squamous cell carcinoma
- GJA1 promotes hepatocellular carcinoma progression by mediating TGF-β-induced activation and the epithelial–mesenchymal transition of hepatic stellate cells
- lncRNA-ZFAS1 promotes the progression of endometrial carcinoma by targeting miR-34b to regulate VEGFA expression
- Anticoagulation is the answer in treating noncritical COVID-19 patients
- Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT
- Comparison of Dako HercepTest and Ventana PATHWAY anti-HER2 (4B5) tests and their correlation with silver in situ hybridization in lung adenocarcinoma
- VSTM1 regulates monocyte/macrophage function via the NF-κB signaling pathway
- Comparison of vaginal birth outcomes in midwifery-led versus physician-led setting: A propensity score-matched analysis
- Treatment of osteoporosis with teriparatide: The Slovenian experience
- New targets of morphine postconditioning protection of the myocardium in ischemia/reperfusion injury: Involvement of HSP90/Akt and C5a/NF-κB
- Superenhancer–transcription factor regulatory network in malignant tumors
- β-Cell function is associated with osteosarcopenia in middle-aged and older nonobese patients with type 2 diabetes: A cross-sectional study
- Clinical features of atypical tuberculosis mimicking bacterial pneumonia
- Proteoglycan-depleted regions of annular injury promote nerve ingrowth in a rabbit disc degeneration model
- Effect of electromagnetic field on abortion: A systematic review and meta-analysis
- miR-150-5p affects AS plaque with ASMC proliferation and migration by STAT1
- MALAT1 promotes malignant pleural mesothelioma by sponging miR-141-3p
- Effects of remifentanil and propofol on distant organ lung injury in an ischemia–reperfusion model
- miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway
- Identification of LIG1 and LIG3 as prognostic biomarkers in breast cancer
- MitoQ inhibits hepatic stellate cell activation and liver fibrosis by enhancing PINK1/parkin-mediated mitophagy
- Dissecting role of founder mutation p.V727M in GNE in Indian HIBM cohort
- circATP2A2 promotes osteosarcoma progression by upregulating MYH9
- Prognostic role of oxytocin receptor in colon adenocarcinoma
- Review Articles
- The function of non-coding RNAs in idiopathic pulmonary fibrosis
- Efficacy and safety of therapeutic plasma exchange in stiff person syndrome
- Role of cesarean section in the development of neonatal gut microbiota: A systematic review
- Small cell lung cancer transformation during antitumor therapies: A systematic review
- Research progress of gut microbiota and frailty syndrome
- Recommendations for outpatient activity in COVID-19 pandemic
- Rapid Communication
- Disparity in clinical characteristics between 2019 novel coronavirus pneumonia and leptospirosis
- Use of microspheres in embolization for unruptured renal angiomyolipomas
- COVID-19 cases with delayed absorption of lung lesion
- A triple combination of treatments on moderate COVID-19
- Social networks and eating disorders during the Covid-19 pandemic
- Letter
- COVID-19, WHO guidelines, pedagogy, and respite
- Inflammatory factors in alveolar lavage fluid from severe COVID-19 pneumonia: PCT and IL-6 in epithelial lining fluid
- COVID-19: Lessons from Norway tragedy must be considered in vaccine rollout planning in least developed/developing countries
- What is the role of plasma cell in the lamina propria of terminal ileum in Good’s syndrome patient?
- Case Report
- Rivaroxaban triggered multifocal intratumoral hemorrhage of the cabozantinib-treated diffuse brain metastases: A case report and review of literature
- CTU findings of duplex kidney in kidney: A rare duplicated renal malformation
- Synchronous primary malignancy of colon cancer and mantle cell lymphoma: A case report
- Sonazoid-enhanced ultrasonography and pathologic characters of CD68 positive cell in primary hepatic perivascular epithelioid cell tumors: A case report and literature review
- Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB
- Pulmonary parenchymal involvement caused by Tropheryma whipplei
- Mediastinal mixed germ cell tumor: A case report and literature review
- Ovarian female adnexal tumor of probable Wolffian origin – Case report
- Rare paratesticular aggressive angiomyxoma mimicking an epididymal tumor in an 82-year-old man: Case report
- Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review
- Primary orbital ganglioneuroblastoma: A case report
- Primary aortic intimal sarcoma masquerading as intramural hematoma
- Sustained false-positive results for hepatitis A virus immunoglobulin M: A case report and literature review
- Peritoneal loose body presenting as a hepatic mass: A case report and review of the literature
- Chondroblastoma of mandibular condyle: Case report and literature review
- Trauma-induced complete pacemaker lead fracture 8 months prior to hospitalization: A case report
- Primary intradural extramedullary extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) of the thoracolumbar spine: A case report and literature review
- Computer-assisted preoperative planning of reduction of and osteosynthesis of scapular fracture: A case report
- High quality of 58-month life in lung cancer patient with brain metastases sequentially treated with gefitinib and osimertinib
- Rapid response of locally advanced oral squamous cell carcinoma to apatinib: A case report
- Retrieval of intrarenal coiled and ruptured guidewire by retrograde intrarenal surgery: A case report and literature review
- Usage of intermingled skin allografts and autografts in a senior patient with major burn injury
- Retraction
- Retraction on “Dihydromyricetin attenuates inflammation through TLR4/NF-kappa B pathway”
- Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part I
- An artificial immune system with bootstrap sampling for the diagnosis of recurrent endometrial cancers
- Breast cancer recurrence prediction with ensemble methods and cost-sensitive learning
