To reach the pressures and densities required for ignition, it may be necessary to develop an approach to design that makes it easier for simulations to guide experiments. Here, we report on a new ...short-pulse inertial confinement fusion platform that is specifically designed to be more predictable. The platform has demonstrated 99%+0.5% laser coupling into the hohlraum, high implosion velocity (411 km/s), high hotspot pressure (220+60 Gbar), and high cold fuel areal density compression ratio (>400), while maintaining controlled implosion symmetry, providing a promising new physics platform to study ignition physics.
Background
The impact of a wide surgical margin on the outcome of patients with hepatocellular carcinoma (HCC) has not been evaluated in relation to the type of liver resection performed, anatomical ...or non‐anatomical. The aim of this study was to evaluate the impact of surgical margin status on outcomes in patients undergoing anatomical or non‐anatomical resection for solitary HCC.
Methods
Data from patients with solitary HCC who had undergone non‐anatomical partial resection (Hr0 group) or anatomical resection of one Couinaud segment (HrS group) between 2000 and 2007 were extracted from a nationwide survey database in Japan. Overall and recurrence‐free survival associated with the surgical margin status and width were evaluated in the two groups.
Results
A total of 4457 patients were included in the Hr0 group and 3507 in the HrS group. A microscopically positive surgical margin was associated with poor overall survival in both groups. A negative but 0‐mm surgical margin was associated with poorer overall and recurrence‐free survival than a wider margin only in the Hr0 group. In the HrS group, the width of the surgical margin was not associated with patient outcome.
Conclusion
Anatomical resection with a negative 0‐mm surgical margin may be acceptable. Non‐anatomical resection with a negative 0‐mm margin was associated with a less favourable survival outcome.
Antecedentes
El impacto de un margen quirúrgico (surgical margin, SM) amplio en el resultado de pacientes con carcinoma hepatocelular (hepatocellular carcinoma, HCC) no ha sido evaluado en relación con el tipo de resección hepática realizada: anatómica o no anatómica. El objetivo del presente estudio fue evaluar el impacto del estado del SM en los resultados en pacientes sometidos a resección anatómica o no anatómica por un HCC solitario.
Métodos
Los datos de pacientes con un HCC solitario sometidos a resección parcial no anatómica (grupo Hr0) o resección anatómica de un segmento de Couinaud (grupo HrS) entre 2000 y 2007 se obtuvieron a partir de una base de datos nacional de Japón. En los grupos Hr0 y HrS se evaluaron la supervivencia global y la supervivencia libre de recidiva asociadas al estado microscópico del SM y a la amplitud del SM.
Resultados
Se incluyeron un total de 4.457 pacientes en el grupo Hr0 y 3.507 en el grupo HrS. Un SM microscópico positivo se asoció con una pobre supervivencia global en ambos grupos. Un SM negativo, pero a una distancia de 0 mm se asoció con una peor supervivencia global y libre de recidiva en comparación con aquellos asociados a un SM más amplio, solo en el grupo Hr0. En el grupo HrS, la amplitud del SM no se asoció con los resultados del paciente.
Conclusión
La resección anatómica con un SM negativo a una distancia de 0 mm puede ser aceptable. La resección no anatómica con un SM negativo a una distancia de 0 mm se asoció con resultados de supervivencia menos favorables.
Data of patients in Japan with hepatocellular carcinoma who had undergone a non‐anatomical or anatomical resection were extracted from a nationwide survey database. A microscopically positive margin was associated with poorer overall survival. The outcome of patients with a negative but 0‐mm margin was poor only in the non‐anatomical resection group, suggesting that anatomical resection with a negative 0‐mm margin is acceptable.
Difference between anatomic and non‐anatomic resection
The efficacy of hepatic arterial infusion chemotherapy for the treatment of advanced hepatocellular carcinoma (HCC) remains unclear.
The outcome of 476 patients with HCC who underwent hepatic ...arterial infusion chemotherapy with 5-fluorouracil and cisplatin (HAIC) were compared with 1466 patients who did not receive active therapy.
A survival benefit of the therapy after adjusting for known risk factors was observed (hazard ratio, 0.48; 95% CI, 0.41-0.56; P<0.0001). In propensity score-matched analysis (n=682), median survival time was longer for patients who underwent chemotherapy (14.0 months) than for patients who did not receive active treatment (5.2 months, P<0.0001).
For advanced HCC, HAIC is considered to be an effective treatment.
Laser redirection by cross-beam power transfer in a plasma is an important example of a nonlinear optics process which uses laser-plasma instabilities to one's advantage. We have demonstrated this in ...a hohlraum plasma at the National Ignition Facility (NIF) at Lawrence Livermore National Laboratory. A four-wave mixing process causes laser power in multiple beams to change direction and add to the laser power of a selected beam. The process is controlled by setting the wavelength separation of the interacting laser beams. This technique provides a method to remotely re-point or combine high-powered laser beams without the need of local optical apparatus. PUBLICATION ABSTRACT
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