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IF 3.5 2区医学

Ejso Pub Date : 2024-09-17 DOI: 10.1016/S0748-7983(24)00731-5

引用次数: 0

Effect of postoperative normothermic intraperitoneal chemotherapy on the prognosis of MPM patients receiving CRS+HIPEC: A single-center case-control study 术后常温腹腔化疗对接受CRS+HIPEC治疗的MPM患者预后的影响：单中心病例对照研究

IF 3.5 2区医学

Ejso Pub Date : 2024-09-14 DOI: 10.1016/j.ejso.2024.108692

{"title":"Effect of postoperative normothermic intraperitoneal chemotherapy on the prognosis of MPM patients receiving CRS+HIPEC: A single-center case-control study","authors":"","doi":"10.1016/j.ejso.2024.108692","DOIUrl":"10.1016/j.ejso.2024.108692","url":null,"abstract":"<div><h3>Background</h3><p>The comprehensive treatment strategy, mainly cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC), combined with systemic and intraperitoneal chemotherapy, is the standard treatment for malignant peritoneal mesothelioma (MPM), which can significantly prolong the survival of patients. The aim of this study is to investigate the clinical significance of postoperative normothermic intraperitoneal chemotherapy (NIPEC) in MPM patients.</p></div><div><h3>Methods</h3><p>Data of 152 MPM patients who underwent CRS + HIPEC and postoperative intravenous chemotherapy were retrospectively analyzed. Patients were divided into the Non-NIPEC group and the NIPEC group according to whether they received NIPEC after surgery. The baseline characteristics of the two groups were compared, and the survival outcome was analyzed in subgroups according to completeness of cytoreduction (CC) score. Multivariate survival analysis was used to determine the independent prognostic factors.</p></div><div><h3>Results</h3><p>In CC 0–1 and CC 2–3 subgroups, there was no significant difference in baseline characteristics between Non-NIPEC and NIPEC groups. Survival analysis showed that for CC 0–1 patients, there was no significant difference in overall survival (OS) between Non-NIPEC and NIPEC groups (<em>P</em> = 0.503). However, for CC 2–3 patients, the median OS of the NIPEC group was significantly longer than that of the Non-NIPEC group (24.5 <em>vs.</em> 10.3 months, <em>P</em> = 0.005). Pathological type, preoperative thrombosis and postoperative NIPEC (HR = 0.423, 95%CI: 0.228–0.786, <em>P</em> = 0.006) were independent prognostic factors for CC 2–3 patients.</p></div><div><h3>Conclusions</h3><p>For MPM patients receiving CRS + HIPEC, postoperative intraperitoneal combined with intravenous chemotherapy may improve the survival of CC 2–3 patients, but CC 0–1 patients do not seem to derive the same benefit.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the editor: Transforming cancer care: The vital role of prehabilitation in colorectal surgery 致编辑的信转变癌症护理：结直肠手术前康复的重要作用

IF 3.5 2区医学

Ejso Pub Date : 2024-09-14 DOI: 10.1016/j.ejso.2024.108694

引用次数: 0

Preoperative geriatric assessment to predict functional outcome after major urologic operations: Results from a multicenter study 通过术前老年病学评估预测泌尿外科大手术后的功能预后：一项多中心研究的结果

IF 3.5 2区医学

Ejso Pub Date : 2024-09-14 DOI: 10.1016/j.ejso.2024.108693

{"title":"Preoperative geriatric assessment to predict functional outcome after major urologic operations: Results from a multicenter study","authors":"","doi":"10.1016/j.ejso.2024.108693","DOIUrl":"10.1016/j.ejso.2024.108693","url":null,"abstract":"<div><h3>Introduction</h3><p>Major urological tumor surgery entails a severe risk of unexpected adverse events, persistent functional deterioration, and death in older patients. The Erlangen Index (EI) geriatric assessment tool has previously been shown to predict incomplete functional recovery following major urological tumor surgery in an elderly patient collective. We prospectively evaluated assessment tools including EI in a multicenter setting.</p></div><div><h3>Materials and methods</h3><p>A total of 340 patients over the age of 65 were assessed prospectively before and after cystectomy, prostatectomy, or renal tumor surgery at three academic centers in Germany and Austria. Endpoints were long-term functional deterioration (Activities of daily living (ADL) measured by Barthel-Index) at day 30 and day 180, and mortality at day 180.</p></div><div><h3>Results</h3><p>In this study 58 (17.0 %) patients underwent cystectomy, 140 (41.2 %) prostatectomy and 142 (41.8 %) a kidney tumor operation. Mean age was 74.8 years. ADL impairment as a measure of incomplete recovery at day 30 and 180 after surgery were recorded in 47.6 % and 37.4 % of cases, respectively. The EI showed good sensitivity for mortality at day 180 (reference cohort: 85 %, validation center 1: 100 %, validation center 2: 50 %) and for ADL impairment at day 180 (reference cohort 75.4 %, validation center 1 72.3 %, validation center 2 83.3 %).</p></div><div><h3>Conclusion</h3><p>Elderly patients with a poor performance status have a high risk of persistent functional deterioration. Data from this multicenter external validation trial confirms the EI as an accurate and reliable tool to identify patients with high risk of mortality or persistent postoperative functional impairment.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0748798324007455/pdfft?md5=9ae8875954be95d773421a4eea3465d3&pid=1-s2.0-S0748798324007455-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multidisciplinary team meetings and their impact on survival in rectal cancer. Population-based analysis in Catalonia (Spain) 多学科团队会议及其对直肠癌患者生存率的影响。加泰罗尼亚（西班牙）的人群分析

IF 3.5 2区医学

Ejso Pub Date : 2024-09-12 DOI: 10.1016/j.ejso.2024.108675

{"title":"Multidisciplinary team meetings and their impact on survival in rectal cancer. Population-based analysis in Catalonia (Spain)","authors":"","doi":"10.1016/j.ejso.2024.108675","DOIUrl":"10.1016/j.ejso.2024.108675","url":null,"abstract":"<div><h3>Background</h3><p>Multidisciplinary team meetings (MTMs) are considered a pillar of cancer care; however, evidence of the independent benefit of MTMs on survival in rectal cancer is controversial.</p></div><div><h3>Methods</h3><p>This population-based cohort analysis included patients undergoing surgery for primary rectal cancer with curative intent. We drew data derived from three clinical audits conducted in Catalonia from 2011 to 2020. The primary outcome was 2-year survival. Multivariable Cox regression analysis was used to assess the hazard ratio for death in patients whose cases were versus were not discussed in a preoperative MTM.</p></div><div><h3>Results</h3><p>A total of 5249 patients were included (66.1 % male, 58.3 % aged 60–79 years, 63.2 % receiving anterior resection): 4096 cases were discussed in a preoperative MTM, and 1153 were not. Multivariable Cox proportional hazards regression analysis showed that the MTM group had better survival than those with no preoperative MTM (hazard ratio 1.22, 95 % confidence interval 1.02–1.48), after adjusting for potential confounders.</p></div><div><h3>Conclusions</h3><p>Preoperative MTM may be associated with improved survival in patients with rectal cancer in Catalonia. Efforts to ensure universal access to MTMs for all newly diagnosed patients should be supported.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative blood transfusions associated with reduced survival in gastroesophageal cancers – A Swedish population-based study 围手术期输血与胃食管癌患者生存率降低有关--一项基于瑞典人群的研究

IF 3.5 2区医学

Ejso Pub Date : 2024-09-12 DOI: 10.1016/j.ejso.2024.108690

{"title":"Perioperative blood transfusions associated with reduced survival in gastroesophageal cancers – A Swedish population-based study","authors":"","doi":"10.1016/j.ejso.2024.108690","DOIUrl":"10.1016/j.ejso.2024.108690","url":null,"abstract":"<div><h3>Background</h3><p>Blood transfusion has been associated with decreased long-term survival in cancer patients, possibly due to various immunological factors. We aimed to evaluate if perioperative transfusions decrease survival in patients who undergo resection for esophageal or gastric cancer and to identify factors associated with such events.</p></div><div><h3>Methods</h3><p>A population-based cohort study was conducted based on the Swedish National Registry for Esophageal and Gastric Cancer, which prospectively collects clinical data of patients with these tumors. Almost all patients (96 %) resected for esophageal or gastric cancer in Sweden between 2017 and 2022 were included. Survival data were acquired from the Swedish Cause of Death Registry. Multivariable Cox regression was used to calculate hazard ratios (HR) with 95 % confidence intervals (CI), adjusted for age, fitness, neoadjuvant therapy, surgical access, and pathological TNM stage.</p></div><div><h3>Results</h3><p>Of all 1365 patients, 227 (17 %) received perioperative transfusions. Transfusion was associated with an increased risk of all-cause mortality within 3 years of surgery (adjusted HR 1.50, 95 % CI 1.17–1.91). To exclude the influence of surgery-related postoperative complications, a sensitivity analysis was performed excluding patients who died within 30 days of resection and the negative impact of transfusions on 3-year mortality remained (adjusted HR 1.30, 95 % CI 1.01–1.68). Increasing age, open surgery, esophagectomy, perioperative bleeding, and nodal tumor involvement were all associated with an increased likelihood of receiving transfusions.</p></div><div><h3>Conclusion</h3><p>Perioperative blood transfusions might have a negative impact on 3-year survival in patients who undergo surgery for esophageal or gastric cancer.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S074879832400742X/pdfft?md5=2a252f11a96a04aadcf9bc2cbbb475de&pid=1-s2.0-S074879832400742X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prehab, ERAS, Rehab: A patient care continuum around colo-rectal surgery 康复前、ERAS、康复：结肠直肠手术患者护理的连续性

IF 3.5 2区医学

Ejso Pub Date : 2024-09-12 DOI: 10.1016/j.ejso.2024.108688

{"title":"Prehab, ERAS, Rehab: A patient care continuum around colo-rectal surgery","authors":"","doi":"10.1016/j.ejso.2024.108688","DOIUrl":"10.1016/j.ejso.2024.108688","url":null,"abstract":"<div><h3>Background</h3><p>Prehabilitation (Prehab) programs aim to optimize patients psycho-physical condition before surgery, to improve post-operative outcomes. Although functional benefits of Prehab are known, the clinical impact does not yet have concrete evidence. The objective of this study is to evaluate the efficacy of Prehab, associated with Enhanced Recovery After Surgery (ERAS) and surgical rehabilitation (Rehab), in frail colorectal oncological patients in terms of morbidity and hospitalization.</p></div><div><h3>Patients and methods</h3><p>The cohort of patients undergoing Prehab between January 2020 and December 2022 (Prehab group) is compared with the historical cohort of patients operated on in the period 01/2018-12/2019, not undergoing Prehab (no-Prehab group). Prehab scheme: multimodal (physiotherapy, clinical nutrition and psychological support). All patients followed an ERAS path. Only Prehab patients followed a surgical Rehab by a dedicated nurse case-manager. Propensity score matching (PSM) and weighting (PSW) analyses were used for statistical analysis. Primary objectives: complications at 30 days and hospital stay. Secondary objectives: functional outcomes.</p></div><div><h3>Results</h3><p>In 3 years of preliminary enrollment, 36 patients completed the program: 22 in person, 16 in tele-prehab. The Prehab group experienced fewer complications than the no-Prehab group (PSM: 31 % vs 53 % p = 0.02; PSW: 31 % vs 51 % p = 0.02), less severe complications (CCI>20 PSM: 17 % vs 33 % p = 0.074; PSW: 17 % vs 53 % 0.026) and shorter hospital stay (4.5 vs 6 days; p = 0.02). Finally, prehabilitated patients improved their preoperative functional capacity and reduced anxiety levels.</p></div><div><h3>Conclusion</h3><p>The strategy of combining Prehab with ERAS and Rehab has positively influenced post-operative clinical outcomes as well as functional parameters in our series.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Differences in characteristics and outcomes between early-onset colorectal cancer and late-onset colorectal cancers 早发结直肠癌和晚发结直肠癌的特征和预后差异

IF 3.5 2区医学

Ejso Pub Date : 2024-09-11 DOI: 10.1016/j.ejso.2024.108687

{"title":"Differences in characteristics and outcomes between early-onset colorectal cancer and late-onset colorectal cancers","authors":"","doi":"10.1016/j.ejso.2024.108687","DOIUrl":"10.1016/j.ejso.2024.108687","url":null,"abstract":"<div><h3>Introduction</h3><p>Colorectal cancer (CRC) represents a significant health burden worldwide, with a notable increase in early-onset colorectal cancer (EOCRC) cases, defined as those diagnosed before the age of 50 years.</p></div><div><h3>Materials and methods</h3><p>Using data from Taiwan's national cancer registry and a retrospective cohort from Chang Gung Memorial Hospital, this study analyzed CRC cases diagnosed between 2008 and 2019. The analysis compared the EOCRC and late-onset CRC (LOCRC) groups in terms of clinicopathological characteristics, pre-diagnostic symptoms, and survival outcomes.</p></div><div><h3>Results</h3><p>The analysis revealed a continuous increase in the annual incidence of EOCRC, with colon cancer and rectal cancer rising by 3.2 % and 3.3 %, respectively. Patients with EOCRC presented with more aggressive disease characteristics, such as signet-ring cell adenocarcinoma, mucinous adenocarcinoma, and poorly differentiated grade. Advanced stages at diagnosis, stages III and IV, were more common with EOCRC (62.4 %) than with LOCRC (50.3 %). Patients with EOCRC reported rectal bleeding, changes in bowel habits, and abdominal pain more frequently than those in the LOCRC group. There is a strong association between stool-related symptoms and left-sided CRC. Despite similar surgical outcomes, the 5-year cancer-specific survival rate of patients with stage IV EOCRC was significantly lower than that of patients with LOCRC (32.8 % vs. 51.9 %, p = 0.012).</p></div><div><h3>Conclusion</h3><p>This study highlights a persistent rise in the incidence of EOCRC, with patients presenting with more aggressive disease and experiencing inferior survival. These findings underscore the importance of heightened awareness and early detection strategies for CRC, especially in younger populations, to improve the prognosis.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S074879832400739X/pdfft?md5=8375ed1bf842aad6160d8fa4874f6d0d&pid=1-s2.0-S074879832400739X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Progress of intracranial metastases during the interval before stereotactic radiosurgery, a retrospective cohort analysis 立体定向放射外科手术前颅内转移灶进展情况的回顾性队列分析

IF 3.5 2区医学

Ejso Pub Date : 2024-09-10 DOI: 10.1016/j.ejso.2024.108676

{"title":"Progress of intracranial metastases during the interval before stereotactic radiosurgery, a retrospective cohort analysis","authors":"","doi":"10.1016/j.ejso.2024.108676","DOIUrl":"10.1016/j.ejso.2024.108676","url":null,"abstract":"<div><h3>Introduction</h3><p>The incidence of intracranial metastatic disease is increasing worldwide. As a valuable treatment modality, stereotactic radiosurgery requires detailed imaging, and this study evaluated the differences between imaging obtained on the day of treatment compared to historical or referral imaging.</p></div><div><h3>Materials and methods</h3><p>A retrospective cohort study was performed, evaluating all the patients presenting with eligible referral imaging in a 13-month period and comparing this imaging to the imaging taken on the day of treatment. Numbers of additional metastases, volumes and volume differences among the images were compared.</p></div><div><h3>Results</h3><p>There was a median interval of 19 days between the acquisition of the diagnostic or referral scan and the day of treatment imaging. Even the group that had the shortest interval (up to 2 weeks) showed at least one additional deposit in 50 % of the patients. Volume was increased in 75 % of this group. Longer intervals were associated with higher increases in volume.</p></div><div><h3>Conclusion</h3><p>These results demonstrate the increase in the disease burden in patients with intracranial metastatic disease, in relation to number and volume, in the interval between the referral and treatment imaging. This has significant implications for planning pathways, to ensure that metastatic deposits are not missed or undertreated.</p></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reply to: Vaginal surgery for cervical cancer based on the recent results of LACC, SHAPE, SUCCOR and ConCerv trials. 回复：基于 LACC、SHAPE、SUCCOR 和 ConCerv 试验最新结果的宫颈癌阴道手术。

IF 3.5 2区医学

Ejso Pub Date : 2024-09-07 DOI: 10.1016/j.ejso.2024.108656

Limor Helpman, Laurence Bernard, Gregory Pond

引用次数: 0