Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 13 de 13
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
In Vivo ; 35(6): 3483-3488, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34697185

RESUMO

BACKGROUND: Resection of the primary lesion with radical lymph node dissection is the most promising treatment avenue for patients with cancer. On the other hand, these procedures often induce excessive intraoperative blood loss (IBL) and require perioperative blood transfusion. The influence of IBL on the long-term postoperative outcomes of patients with digestive cancer is controversial. We investigated the impact of IBL on survival and recurrence after curative surgery in patients with colorectal cancer (CRC) in a single study group. PATIENTS AND METHODS: In total, 1,597 patients who underwent radical resection for CRC at three group hospitals between 2000 and 2019 were reviewed. Patients were classified into a group with high IBL (≥200 ml) or low IBL (<200 ml). The risk factors for disease-free (DFS) and overall (OS) survival were analyzed. RESULTS: A total of 489 and 1,108 patients were classified into the high and low IBL groups, respectively. The OS and DFS rates at 5 years after surgery were 89.3% and 63.4%, respectively, for the high IBL group and 96.9% and 77.8% for the low IBL group; these differences were statistically significantly (p<0.001). The multivariate analysis demonstrated that IBL was a significant independent risk factor for OS and DFS. CONCLUSION: The amount of IBL was associated with significant differences in the OS and DFS of patients with stage II/III CRC who received curative resection. The surgical procedure, surgical strategy, and perioperative care should be carefully planned to avoid causing IBL.


Assuntos
Perda Sanguínea Cirúrgica , Neoplasias Colorretais , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Intervalo Livre de Doença , Humanos , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos
2.
Anticancer Res ; 41(10): 5097-5106, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34593460

RESUMO

AIM: D3 lymph node dissection (LND) for stage II and III colon cancer has been shown to improve prognosis, however, it generally increases surgical stress. Studies have reported that the C-reactive protein/albumin ratio (CAR) may be a useful inflammatory-nutritional biomarker to predict postoperative complications and poor prognosis for with various types of cancer. Our purposes were to assess the short- and long-term outcomes of D3 LND in patients with a high preoperative CAR (≥ 0.04). PATIENTS AND METHODS: This was a retrospective cohort analysis reviewing a prospectively collected database of Yokohama City University and three affiliated hospitals. A total of 449 patients with stage II or III colon cancer with high CAR who underwent primary resection with D2 or D3 LND were identified between 2008 and 2020. The primary and secondary outcomes of interests were the 3-year recurrence-free survival and postoperative complication rates. RESULTS: After propensity matching, 230 patients were evaluated. There was no significant difference between the D3 and D2 groups in the rate of postoperative complications overall (14.8% versus 11.3%, p=0.558), however, the incidence of anastomotic leakage tended to be greater in the D3 group (9.6% versus 2.6%, p=0.050). The long-term findings showed that there was no significant difference between the two groups (3-year recurrence-free survival rate: 77.2% versus 77.2%, p=0.880). CONCLUSION: D3 LND did not improve survival outcomes for patients with colon cancer with a poor CAR in this study. D2 LND may be a treatment option for patients with stage II-III colon cancer with a high preoperative CAR.


Assuntos
Albuminas/metabolismo , Biomarcadores Tumorais/metabolismo , Proteína C-Reativa/metabolismo , Neoplasias do Colo/mortalidade , Excisão de Linfonodo/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/metabolismo , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Pontuação de Propensão , Estudos Prospectivos , Estudos Retrospectivos , Taxa de Sobrevida
3.
Anticancer Res ; 41(10): 5195-5202, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34593472

RESUMO

BACKGROUND/AIM: Population aging results in increasing numbers of elderly persons undergoing surgery for colorectal cancer. We sought to identify objective preoperative indicators of outcomes, with a view toward development of safe, effective treatments for such patients. PATIENTS AND METHODS: The study included 99 patients aged 80 years or more, who were treated surgically for stage I- III colorectal cancer. Preoperative nutritional status was compared retrospectively between those who suffered postoperative complications (n=40) and those who did not (n=59). RESULTS: Univariate analysis revealed low prealbumin (PreAlb) concentration (p=0.032) and low platelet-to-lymphocyte ratio (p=0.116) as risk factors for postoperative complications. Multivariate analysis showed preoperative PreAlb concentration to be an independent risk factor (OR=0.884; 95% confidence interval=0.791-0.989; p=0.024) associated with postoperative length of hospital stay (coef.=-0.336, p=0.002). CONCLUSION: PreAlb, a rapid turnover protein, shows promise as a simple predictor of postoperative complications in elderly patients treated for colorectal surgery.


Assuntos
Albuminas/metabolismo , Biomarcadores Tumorais/metabolismo , Neoplasias Colorretais/mortalidade , Tempo de Internação/estatística & dados numéricos , Cuidados Pré-Operatórios , Idoso de 80 Anos ou mais , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Cirurgia Colorretal , Feminino , Seguimentos , Humanos , Masculino , Estado Nutricional , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
4.
J Surg Oncol ; 2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34704609

RESUMO

BACKGROUND AND OBJECTIVES: Contrary to the Japanese guidelines recommendations regarding lateral lymph node dissection (LatLND) for rectal cancer, its omission is common in clinical practice without reliable omission criteria. Negative pathological mesorectal lymph node metastasis (MesLNM) is reportedly highly correlated with negative pathological lateral lymph node metastasis (p-LatLNM); however, this cannot be used as a criterion because pathological features are revealed postoperatively. Herein, we prospectively evaluated the negative predictive value (NPV) of MesLNM diagnosed via the one-step nucleic acid amplification (OSNA) method for p-LatLNM. METHODS: This prospective study was conducted at a single academic study group in Japan. The key eligibility criterion was mid-to-low rectal cancer planned to be treated using mesorectal excision with LatLND. According to the study protocol, the OSNA method was considered useful if the point estimate of the NPV exceeded 95%. RESULTS: Preoperative case registration was conducted between 2018 and 2020; 34 patients were registered. Among these, 16 were negative for OSNA-MesLNM, and negative p-LatLNM was confirmed in all cases. The point estimate of the NPV was 100%, with the 95% confidence interval ranging from 79.4% to 100.0%. CONCLUSIONS: The OSNA method is useful in selecting patients in whom LatLND can be omitted in real-world clinical practice.

5.
Anticancer Res ; 41(5): 2617-2623, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33952492

RESUMO

AIM: To compare the mid-term oncological results between patients with low rectal cancer who underwent minimally invasive laparoscopic surgery (MILS) and those who underwent open surgery (OS). PATIENTS AND METHODS: Overall, 262 matched patients who underwent primary resection for low rectal cancer between 2000 and 2019 were divided into MILS (n=131; n=107, conventional laparoscopic surgery; n=24, robotic surgery) and OS (n=131) groups. The short- and mid-term outcomes were compared. RESULTS: Similar baseline characteristics were noted. The operative time was longer and blood loss was lesser in the MILS group; the conversion rate was 3.8%. The incidence of postoperative complications was similar. The 2-year cumulative incidence of local recurrence was noted to be much lower in the MILS group (1.9%) than in the OS group (8.4%). MILS had a significantly low hazard ratio (0.208, p=0.036). CONCLUSION: MILS has potential benefits in reducing local recurrence of low rectal cancer.


Assuntos
Laparoscopia , Procedimentos Cirúrgicos Minimamente Invasivos , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retais/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/patologia , Neoplasias Retais/epidemiologia , Neoplasias Retais/patologia
6.
ANZ J Surg ; 91(4): E196-E202, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33559326

RESUMO

BACKGROUND: The search for high-risk factors in stage II colon cancer (CC) is ongoing and several high-risk factors for stage II CC have been identified; however, the effects of tumour sidedness on prognosis are not clear. This study aims to determine whether tumour sidedness could be identified as another high-risk factor for stage II CC. METHODS: We retrospectively analysed 189 patients with stage II CC and compared clinicopathological findings and long-term outcomes between the patients with right colonic cancer (RCC) and with left colonic cancer (LCC). Prognostic factors for survival were determined using univariate and Cox proportional regression analyses. RESULTS: A total of 72 patients were diagnosed with RCC and 117 patients were diagnosed with LCC. Patients with RCC were significantly older (P < 0.001), and the number of harvested lymph nodes was greater in the RCC group (RCC: 25 versus LCC: 19; P = 0.003). The overall survival (OS) was worse in the RCC group than the OS in the LCC group (5-year survival rate - RCC: 81.3% versus LCC: 90.4%; P = 0.025). Cox proportional regression analysis showed that tumour sidedness was an independent prognostic factor for both OS (hazard ratio (HR) 3.78, 95% confidence interval (CI) 1.61-8.85, P = 0.022) and DFS (HR 2.58, 95% CI 1.33-4.99, P = 0.005). CONCLUSION: Patients with RCC have more negative prognostic factors and worse long-term outcomes than those with LCC in stage II CC. Tumour sidedness is a high-risk factor in stage II CC patients.


Assuntos
Neoplasias do Colo , Neoplasias do Colo/patologia , Humanos , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
7.
In Vivo ; 34(6): 3661-3667, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33144482

RESUMO

BACKGROUND/AIM: The current study aimed to identify the safety and efficacy of Hartmann's procedure (HP) among elderly patients (age ≥80 years) with rectal cancer. PATIENTS AND METHODS: Data on surgical outcome, survival rate, and incidence of stoma reversal were retrospectively compared between patients aged over 80 years who underwent anterior resection (AR) and HP. RESULTS: In total, 79 elderly patients underwent rectal cancer surgery. Of these patients, 54 (68.4%) underwent AR and 25 (31.6%) HP. The two groups did not differ significantly in terms of age, nutrient status, and tumor characteristics. Eight (14.8%) patients who underwent AR and six (24.0%) who underwent HP presented with intra-abdominal complications (p=0.35). The overall survival and recurrent-free survival rates between the two groups did not differ. CONCLUSION: HP for elderly patients with rectal cancer has similar complication rates to AR, and achieved similar oncological outcomes.


Assuntos
Complicações Pós-Operatórias , Neoplasias Retais , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Colostomia , Humanos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Neoplasias Retais/cirurgia , Reto/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
8.
Anticancer Res ; 40(3): 1587-1595, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32132061

RESUMO

BACKGROUND/AIM: The purpose of this study was to evaluate the usefulness of minimally invasive esophagectomy (MIE) for stage II/III esophageal cancer (EC). PATIENTS AND METHODS: We compared surgical outcomes between MIE and open esohagectomy in EC patients with pStage II/III using the propensity scoring system. RESULTS: Fifty-seven patients were classified into the MIE group and 57 patients into the open esophagectomy (OE) group. The incidence of major complications was similar between the two groups. The 5-year OS was significantly better in the MIE group (69.0% vs. 35.5%; p=0.004) and no significant difference was observed in the 5-year recurrence-free survival (RFS, 52.2% vs. 29.2%; p=0.064). Multivariate analysis showed MIE was a prognostic factor of OS (p<0.001) and RFS (p=0.032). CONCLUSION: MIE was as safe and feasible as OE, and an independent prognostic factor for OS and RFS in patients with stage II/III EC.


Assuntos
Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Cirurgia Torácica Vídeoassistida/métodos , Cirurgia Vídeoassistida/métodos , Idoso , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Estadiamento de Neoplasias , Pontuação de Propensão , Taxa de Sobrevida , Resultado do Tratamento
9.
In Vivo ; 33(4): 1243-1248, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31280215

RESUMO

BACKGROUND/AIM: The purpose of this study was to reveal the safety and efficacy of additional surgical resection (ASR) for high-risk T1 colorectal cancer (CRC) after endoscopic resection (ER). PATIENTS AND METHODS: We retrospectively analyzed 191 patients with high-risk T1 CRC after ER. RESULTS: The ASR was performed in 176 (92.1%) patients and 15 (7.9%) rejected ASR. All patients that underwent ASR experienced R0 resection; laparoscopic surgery was performed in 159 (90.3%) patients. Clavien-Dindo complications ≥grade II occurred in 33 patients (18.8%). Anastomotic leakage (8.5%) and ileus (5.7%) were the most frequent complications. The anus function was preserved in all patients. Metastatic lymph node was detected in 21 (11.9%) patients. There were no deaths or relapses in patients with ASR. One patient without ASR (6.7%) had a lymph node recurrence. CONCLUSION: ASR was safe and effective and is recommended for high-risk T1 CRC patients after ER. A satisfactory long-term outcome can be achieved.


Assuntos
Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/mortalidade , Cirurgia Colorretal/efeitos adversos , Cirurgia Colorretal/métodos , Feminino , Seguimentos , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Retratamento , Resultado do Tratamento , Carga Tumoral
10.
Mol Clin Oncol ; 8(6): 779-784, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29805792

RESUMO

The prevalence of colorectal cancer in the elderly population is increasing; therefore, surgical interventions with a risk of potential complications are more frequently performed. The aim of the present study was to elucidate whether sarcopenia has a clinical impact on short-term outcomes, such as morbidity and hospital stay after surgery, in elderly patients with colorectal cancer. A total of 82 elderly patients undergoing colectomy for colorectal cancer between January 2011 and December 2015 in our institute were included in the study, and skeletal muscle mass was measured as total psoas area at the level of the third lumbar vertebra (L3) using enhanced computed tomography scans. The patients were divided into two subgroups, namely those with and those without sarcopenia, based on median skeletal muscle mass in men and women, and the association with complications was analyzed. A total of 40 patients (48.8%) were diagnosed with sarcopenia. The patients with sarcopenia exhibited a significantly higher incidence of total complications (55 vs. 31.0%, P=0.028) and longer hospital stay (25.9±21.2 vs. 18.2±8.5 days, P=0.039). The multivariate logistic analysis revealed that sarcopenia was an independent risk factor for postoperative surgical complications. The short-term outcomes, such as postoperative surgical complications and hospital stay, were affected by preoperative sarcopenia in elderly colorectal cancer patients. To improve the short-term outcomes of such patients, it is necessary to carefully plan the surgical procedure, perioperative care and the surgical strategy using preoperative sarcopenia assessment.

11.
Anticancer Res ; 38(3): 1677-1683, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29491102

RESUMO

BACKGROUND/AIM: The purpose of this study was to reveal the optimal lymph node (LN) dissection in remnant gastric cancer (RGC) patients. PATIENTS AND METHODS: We retrospectively analyzed 46 RGC patients divided into two groups: patients who underwent initial gastrectomy for benign (group B) and malignant (group M) diseases. RESULTS: Metastasis was more frequently observed at the left (nos. 2, 4sa, 4sb, 10, and 11p/d) and right (nos. 1, 3, 4d, 7, 8a, and 12a) side LNs of RGC in groups M and B. Modified IEBLD scores (frequency of LN metastasis by median survival time of patients with metastatic LNs) were high at station nos. 10 (4.7), 11p/d (4.3/9.9), and 16 (4.3) in group M and nos. 1 (2.1), 7 (1.9) and mesojejunal (3.0) in group B. CONCLUSION: After lymphadenectomy for initial gastric cancer, lymphatic flow toward the splenic artery was predominant. Therefore, splenectomy with para-aortic LN dissection is an option.


Assuntos
Gastrectomia/métodos , Coto Gástrico/cirurgia , Excisão de Linfonodo/métodos , Neoplasias Gástricas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Coto Gástrico/patologia , Humanos , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Esplenectomia/métodos , Neoplasias Gástricas/patologia , Análise de Sobrevida , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...