Publications by authors named "Chia-Hsun Hsieh"

Article Synopsis
  • Cancer mortality is linked to recurrence and metastasis, making real-time tracking challenging due to current invasive methods, but circulating tumor cells (CTCs) may offer a non-invasive solution despite their scarcity.
  • A study validated a simple culture protocol to grow CTCs in a lab and analyzed how the growth of these cells correlates with clinical response in patients.
  • Results showed significant differences in CTC growth rates based on the patients’ disease status, indicating that CTC growth could be a useful predictor for cancer response and informing how long and under what conditions to observe them in culture.
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Background: Biliary tract cancer (BTC) is an aggressive biliary tract cancer, arising from the bile ducts and gallbladder, with a poor prognosis. The TOPAZ-1 trial of durvalumab plus first-line chemotherapy (gemcitabine plus cisplatin) showed improved survival vs chemotherapy alone. This real-world study aimed to confirm the effectiveness of this regimen.

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Background: The prognostic significance of margin-to-depth ratio (MDR) in oral cavity squamous cell carcinoma (OCSCC) remains unclear, particularly in comparison to traditional margin status. We aimed to examine the association between MDR and clinical outcomes in a large Taiwanese cohort.

Methods: A total of 18,324 patients with first primary OCSCC were categorized by margin status: positive (1013), <5 mm (8371), and ≥ 5 mm (8940).

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Background: The evidence for adjuvant chemoradiotherapy (CRT) of oral cavity squamous cell carcinoma (OCSCC) with extra-nodal extension (ENE) in National Comprehensive Cancer Network (NCCN) guidelines is derived from patients with head and neck cancer. The guidelines further suggest a radiation dose ranging from 6000 to 6600 cGy. In this nationwide study, we sought to evaluate the prognostic significance of adjuvant therapy and the specific radiation dosage in Taiwanese patients with pure OCSCC and ENE.

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Article Synopsis
  • Induction chemotherapy (IC) is used as a treatment prior to surgery for oral squamous cell carcinoma (OCSCC), and this study analyzes its impact on patient survival in Taiwan.
  • A total of 29,891 OCSCC patients were examined, comparing those who had surgery only to those who received IC before surgery, with a focus on survival outcomes through matched analysis.
  • The results show that while overall survival rates were similar for both groups, patients with aggressive pT4a tumors had better outcomes with surgery alone compared to those who received IC before surgery.
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The ability to predict or detect colorectal cancer (CRC) recurrence early after surgery enables physicians to apply appropriate treatment plans and different follow-up strategies to improve patient survival. Overall, 30-50% of CRC patients experience cancer recurrence after radical surgery, but current surveillance tools have limitations in the precise and early detection of cancer recurrence. Circulating tumor cells (CTCs) are cancer cells that detach from the primary tumor and enter the bloodstream.

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Optically induced dielectrophoresis (ODEP)-based microparticle sorting and separation is regarded as promising. However, current methods normally lack the downstream process for the transportation and collection of separated microparticles, which could limit its applications. To address this issue, an ODEP microfluidic chip encompassing three microchannels that join only at the central part of the microchannels (i.

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Article Synopsis
  • Elective tracheotomy is often performed on patients with resected oral squamous cell carcinoma (OCSCC) to help keep their airways open, but its necessity varies among surgeons.
  • A large study including over 18,000 OCSCC patients found that those who had tracheotomies had lower 5-year disease-specific and overall survival rates compared to those who didn't, even after adjusting for other factors.
  • Despite the survival rates being similar after matching groups for other variables, patients with tracheotomies generally experienced longer hospital stays, indicating the procedure may be associated with more complications or extended recovery times.
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Article Synopsis
  • This study compared clinical outcomes between initial surgery and primary definitive radiotherapy (RT) for Taiwanese patients with cT1-2N0M0 oral cavity squamous cell carcinoma (OCSCC) between 2011 and 2019.
  • After analyzing data from over 13,500 patients and matching groups for fairness, the results showed much higher 5-year disease-specific survival rates (DSS) for the surgery group compared to the RT group (86% vs. 58%).
  • The findings suggest that initial surgery significantly improves survival outcomes in these patients, highlighting a notable survival gap of 30% between the two treatment modalities.
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This study compared the effects of megestrol acetate (MA) prophylactic (p-MA) versus reactive (r-MA) use for critical body-weight loss (>5% from baseline) during concurrent chemoradiotherapy (CCRT) in patients with advanced pharyngolaryngeal squamous cell carcinoma (PLSCC). Patients receiving CCRT alone in two phase-II trials were included for analyses. Both the p-MA and r-MA cohorts received the same treatment protocol at the same institution, and the critical body-weight loss, survival, and adverse event profiles were compared.

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Background: Oxaliplatin is commonly used to treat gastrointestinal malignancies. However, its applications are limited due to potential adverse drug reactions (ADRs), particularly severe anaphylactic shock. There is no method to predict or prevent ADRs caused by oxaliplatin.

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Background: Atezolizumab plus bevacizumab (atezo-bev) has been recommended for advanced hepatocellular carcinoma (HCC). High-dose external beam radiotherapy (RT) is recognized for its excellent local tumor control. The efficacy and safety of concurrent atezo-bev with RT for highly advanced HCC has been minimally explored.

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Article Synopsis
  • * A matched analysis revealed that patients with margins < 1 mm had better disease-specific survival (DSS) and overall survival (OS) rates compared to those with positive margins, with 5-year DSS rates at 71% vs 59% and OS rates at 60% vs 48%.
  • * The findings suggest that OCSCC patients with < 1 mm margins have better prognostic outcomes and different clinical characteristics compared to those with positive margins,
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Lung cancer is the leading cause of cancer-related death worldwide, and ~85% of lung cancers are non-small cell lung cancer (NSCLC), which has a low 5-year overall survival rate and high mortality. Several therapeutic strategies have been developed, such as targeted therapy, immuno-oncotherapy and combination therapy. However, the low survival rate indicates the urgent need for new NSCLC treatments.

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Article Synopsis
  • The study evaluates the effectiveness of elective neck dissection (END) versus neck observation (NO) in patients with early-stage oral cavity squamous cell carcinoma (OCSCC) where the depth of invasion (DOI) exceeds 3 mm, as per current NCCN guidelines.
  • An analysis of 4,723 patients revealed that those who underwent END had significantly better survival rates and neck control compared to those monitored without surgery.
  • Through risk stratification, researchers identified distinct subgroups within the NO group, finding that 26% of low-risk patients achieved positive outcomes comparable to the END group, suggesting some patients might not require immediate surgery.
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The analysis of circulating tumor cells (CTCs) at the molecular level holds great promise for several clinical applications. For this goal, the harvest of high-purity, size-sorted CTCs with different subtypes from a blood sample are important. For this purpose, a two-step CTC isolation protocol was proposed, by which the immunomagnetic beads-based cell separation was first utilized to remove the majority of blood cells.

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Context/objectives: The scarce research on factors associated with surrogate decisional regret overlooks longitudinal, heterogenous decisional-regret experiences and fractionally examines factors from the three decision-process framework stages: decision antecedents, decision-making process, and decision outcomes. This study aimed to fill these knowledge gaps by focusing on factors modifiable by high-quality end-of-life (EOL) care.

Methods: This observational study used a prior cohort of 377 family surrogates of terminal-cancer patients to examine factors associated with their membership in the four preidentified distinct decisional-regret trajectories: resilient, delayed-recovery, late-emerging, and increasing-prolonged trajectories from EOL-care decision making through the first two bereavement years by multinomial logistic regression modeling using the resilient trajectory as reference.

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Analysis of circulating tumor cells (CTCs) holds promise to diagnose cancer or monitor its development. Among the methods, counting CTC numbers in blood samples could be the simplest way to implement it. Nevertheless, its clinical utility has not yet been fully accepted.

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For the rapid detection of bacteria in a blood sample, nucleic acid amplification-based assays are believed to be promising. Nevertheless, the nucleic acids released from the dead blood cells or bacteria could affect the assay performance. This highlights the importance of the isolation of live bacteria from blood samples.

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Background: Family surrogates experience heterogeneous decisional regret and negative long-lasting postdecision impacts. Cross-sectional findings on the associations between decisional regret and surrogates' bereavement outcomes are conflicting and cannot illustrate the directional and dynamic evolution of these associations. In this study, we sought to longitudinally examine the associations between 4 previously identified decisional-regret trajectories and bereavement outcomes among family surrogates of terminally ill patients with cancer.

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Background: Nasopharyngeal carcinoma (NPC) is associated with Epstein-Barr virus (EBV) infection. To test preclinical NPC drugs, we established two patient-derived xenograft (PDX) mouse models, EBV-positive PDX-B13 and EBV-negative PDX-Li41, for drug screening.

Methods: Based on next generation sequencing (NGS) studies, PDX-B13 had CCND1 copy number (CN) gain but CDKN2A CN loss, whereas PDX-Li41 had CDKN2A and RB1 CN loss, TSC1 (negative regulator of mTOR) frameshift deletion mutation, and increased activation of mTOR, a serine/threonine kinase that governs metabolism, autophagy, and apoptosis.

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Perineural invasion (PNI) was quantitatively analyzed in oral squamous cell carcinoma (OSCC) specimens obtained by radical surgery to correlate with survival outcomes. This is a retrospective study that reviewed the Cancer registry data between 2009 and 2015. Inclusion criteria were oral cavity cancer, treatment by radical surgery, presence of PNI, and available pathologic samples for S100 staining.

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Background/objective: Facilitating death preparedness is important for improving cancer patients' quality of death and dying. We aimed to identify factors associated with the four death-preparedness states (no-preparedness, cognitive-only, emotional-only, and sufficient-preparedness) focusing on modifiable factors.

Methods: In this cohort study, we identified factors associated with 314 Taiwanese cancer patients' death-preparedness states from time-invariant socio-demographics and lagged time-varying modifiable variables, including disease burden, physician prognostic disclosure, patient-family communication on end-of-life (EOL) issues, and perceived social support using hierarchical generalized linear modeling.

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Article Synopsis
  • The study investigates the necessity of elective neck dissection (END) for patients with early-stage oral cavity squamous cell carcinoma (OCSCC) classified as cT1N0M0, given that evidence supporting it is weak.
  • It analyzes 3886 patients, with 2065 undergoing END and 1821 under neck observation, showing that while END improves neck control and disease-specific survival rates, the outcomes are similar for patients with low-risk scores (0 or 1).
  • The conclusion recommends performing END when the depth of invasion exceeds 2.5 mm or when tumors are poorly differentiated, suggesting that nearly half of the cT1N0M0 patients may be able to avoid unnecessary surgery without negatively impacting
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Objective: Unprecedently investigate associations of prognostic-awareness-transition patterns with (changes in) depressive symptoms, anxiety symptoms, and quality of life (QOL) during cancer patients' last 6 months.

Methods: In this secondary analysis study, 334 cancer patients in their last 6 months transitioned between four prognostic-awareness states (unknown and not wanting to know, unknown but wanting to know, inaccurate awareness, and accurate awareness), thus constituting three transition patterns: maintaining-accurate-, gaining-accurate-, and maintaining-inaccurate/unknown prognostic awareness. A multivariate hierarchical linear model evaluated associations of the transition patterns with depressive symptoms, anxiety symptoms, and QOL determined at final assessment and by mean difference between the first and last assessment.

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