Background Whether dynamic changes of metabolic syndrome (MetS) affects the subsequent laryngeal cancer occurrence remains unknown. Objective This study investigated the effects of changes of MetS on the incidence of laryngeal cancer due to a lack of knowledge regarding the development of MetS in Korean population. Methods A total of 6,757,048 individuals who received national health checkup in 2009 and follow-up health examination in 2011 were analyzed and followed up until 2018. MetS status included the following categories: MetS-chronic (n = 941,609), MetS-developed (n = 614,229), MetS-recovery (n = 455,835), and MetS-free (n = 4,745,375). Results With a median follow-up duration of 6.403 years, 1,350 subjects were newly diagnosed with laryngeal cancer. Compared to participants without MetS, adjusted hazard ratios (HR) (95% confidence interval) for those with MetS were 1.320 (1.17–1.489) for laryngeal cancer. The HR of laryngeal cancer was found to be increased with increasing number of MetS components. The MetS-developed group had a significantly higher risk of laryngeal cancer than the MetS-free group (HR: 1.296; 95% CI: 1.093–1.537). The MetS-recovery group within two years also had an increased risk of laryngeal cancer compared with the MetS-free group (HR: 1.220; 95% CI: 1.008–1.476). Among MetS components, abdominal obesity had the highest risk of laryngeal cancer (HR: 1.374; 95% CI: 1.123–1.681). Conclusion Changes in MetS status were associated with the risk of laryngeal cancer. Results of this study have implications for etiological investigations and prevention strategies.
Objectives: Gabapentin and pregabalin has been shown to reduce postoperative pain effectively. In this meta-analysis, we aimed to assess the role of preoperative gabapentinoids for attenuating postoperative pain after nasal surgery in patients via a meta-analysis of the literature.Data Sources: PubMed, Scopus, and Cochrane Database. Methods: Literature was screened from inception to December 2015. Nine articles to compare the preoperative administered gabapentinoid (gabapentinoids groups) with a placebo or analgesics (control group) were included for analysis of the outcomes of interest, which included postoperative pain scores, analgesic intakes, or side effects, such as sedation, nausea and vomiting, blurred vision, operative bleeding, dizziness, and headache, during a 24-hour postoperative period.Results: The pain score reported by the physician and need for analgesics during the first 24 hours, postoperatively, in the gabapentinoids group significantly reduced compared with the control. Additionally, the gabapentinoids had no significant effect on the incidences of side effects except blurred vision compared with the control during the 24 hours postoperatively. In the subgroup analyses of these results according to operation type, these subgroups showed similar effects on reducing postoperative pain and adverse effects.Conclusions: Preoperative gabapentinoids could attenuate postoperative pain without significant adverse effects in patients who undergo nasal surgery. However, blurred vision may be a handicap that requires consideration for use and education for patients. Further clinical trials will be of help in supporting the results of this study.
Introduction. Mucosal margins exhibit a mean shrinkage of 30–40% after resection of oral and oropharyngeal cancers, and an adequate in situ surgical margin frequently results in a pathological close margin. However, the impact on prognosis remains unclear. We investigated the impact of a pathological close margin on disease-free survival (DFS) and overall survival (OS). Methods. We retrospectively reviewed the clinicopathological data of 418 patients diagnosed with squamous cell carcinomas of the oral cavity or oropharynx who underwent initial surgery (with curative intent) at our institute between 2010 and 2016. Results. Of the total population, the pathological marginal status of 290 (69.4%) patients was reported as clear (>5 mm), 61 (14.6%) as close (>1 mm, ≤5 mm), and 67 (16.0%) as positive (≤1 mm). The 5-year DFSs were 79.3%, 65.1%, and 52% in patients in the negative margin (group 1), close margin (group 2), and positive margin (group 3) groups, respectively. The difference between groups 1 and 2 was not significant (p = 0.213) but the difference between groups 2 and 3 was (p = 0.034). The 5-year OSs were 79.4%, 84%, and 52.3% in groups 1, 2, and 3, respectively. The difference between groups 1 and 2 was not significant (p = 0.824) but the difference between groups 2 and 3 was (p = 0.001). In multivariate analysis, older age, advanced T stage, and a positive margin were independently prognostic of the 5-year DFS and OS. Conclusion. In conclusion, the OS of patients with close margins was no different than that of others when appropriate postoperative adjuvant and/or salvage treatment were/was prescribed. However, we could not determine the impact of close margins on locoregional recurrence given various biases in our study setting. A future prospective study is needed.
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