No abstract

IntroductionThe principal drawback of surgery for bony metastatic locations, particularly vertebral metastases (VM), is, for many surgeons, the relative frequency of complications due to the procedures themselves. We decided to verify whether this fear is well founded by determining the frequency of immediate and secondary complications of such surgery, and to look for causes or predisposing factors that might point to means for reducing the frequency of these complications. Materials and methodsWe carried out a retrospective study of 145 patients operated in our unit between 1982 and 1991 for vertebral metastasis of malignant tumours. The surgery was indicated to reduce pain, prevent onset or aggravation of neural deficits, and to improve the quality of life of the patients. Primary vertebral tumours were excluded from this series. Vertebral locations of haematological malignancies, which involve problems similar to those encountered in solid tumour metastases, were, on the other hand, included. EpidemiologyPrimary tumor (Table 1) The 145 patients operated were among 155 patients hospitalized between 1982 and 1991 in our unit, for secondary locations of malignant tumours. Among these 155 patients, the primary tumour had already been diagnosed in 103 patients at the time that one or more metastases were detected. Vertebral metastasis was the inaugural manifestation of cancer in the other 52 patients (33.5%).In the majority of cases in which the primary tumour was already known at diagnosis of vertebral metastasis, either breast cancer (n = 39, 37.8%), lung cancer (n = 13, 12.6%) or colon cancer (n = 8, 7.7%, all colic locations combined) was involved.Among the rarer locations were noted tumours of the kidney, prostate, uterus (neck or body), oesophagus and bladder. We classed the even rarer tumours into the category "others" (synoviosarcoma, neuroendocrine carcinoma, leiomyosarcoma, malignant melanoma, malignant fibrous histiocytoma, tumour of the pancreas, tumour of the pharynx), when they were already diagnosed at the time of discovery of VM. AbstractThe authors report their experience concerning complications of spinal metastasis surgery. The purpose of this study was to assess the frequency of such complications and analyse the factors influencing their occurrence. The records of 145 patients treated between 1982 and 1991 for metastatic disease of the spine were retrospectively reviewed for intra-and postoperative complications. Other factors such as radiation therapy, emergent nature of surgery, and neurologic deficits were analysed for potential correlations with the frequency of complications. Twentyseven (18.6%) patients developed postoperative complications. Wound dehiscence and infection (11%) were the most frequent complications. Statistical analysis showed a significant influence of three factors: preoperative radiation therapy, paraplegia before surgery, and surgery under emergency conditions. The rate of complications in this surgery is lower than might be expected and can be significantly reduced....

Background: Tumour extension beyond the mesorectal plane (ymrT4) occurs in 5-10 per cent of patients with rectal cancer and 10 per cent of patients develop locally recurrent rectal cancer (LRRC) after primary surgery. There is global variation in healthcare delivery for these conditions. Methods: An international benchmark trial of the management of ymrT4 tumours and LRRC was undertaken in France and Australia between 2015 and 2017. Heterogeneity in management and operative decision-making were analysed by comparison of surgical resection rates, blinded intercountry reading of pelvic MRI, quality-of-life assessment and qualitative evaluations. Results: Among 154 patients (97 in France and 57 in Australia), 31⋅8 per cent had ymrT4 disease and 68⋅2 per cent LRRC. The surgical resection rates were 88 and 79 per cent in France and Australia respectively (P = 0⋅112). The concordance in operative planning was low (= 0⋅314); the rate of pelvic exenteration was lower in France than Australia both in clinical practice (36 of 78 versus 34 of 40; P < 0⋅001) and in theoretical conditions (10 of 25 versus 50 of 57; P = 0⋅002). The R0 resection rate was lower in France than Australia for LRRC (25 of 49 versus 18 of 21; P = 0⋅007) but not for ymrT4 tumours (21 of 26 versus 15 of 15; P = 0⋅139). Morbidity rates were similar. Patients who underwent non-exenterative procedures had higher scores on the mental functioning subscale at 12 months (P = 0⋅047), and a lower level of distress at 6 months (P = 0⋅049). Qualitative analysis highlighted five categories of psychosocial factors influencing treatment decisions: patient, strategy, specialist, organization and culture. Conclusion: This international benchmark trial has highlighted the differences in worldwide treatment of locally advanced and LRRC. Standardized care should improve outcomes for these patients.

No abstract

Depression, as assessed with the GDS , should be regarded as a relatively stable and enduring trait construct, reflecting a stable core of a person's depressivity. The negligible amount of state elements in the variation of the GDS scores provides evidence that changing the context will not be enough to cause significant changes in depressive symptoms. Copyright © 2016 John Wiley & Sons, Ltd.

Sense of Agency (SoA) is the subject of growing attention. It corresponds to the capacity to claim authorship over an action, associate specific consequences with a specific action, and it has been claimed to be a key point in the development of consciousness. It can be measured using the Sense of Agency Scale (SoAS), originally proposed by Tapal et al. (2017) , who distinguished it into two-factor: Sense of Positive Agency (SoPA) and Sense of Negative Agency (SoNA). This study reports on the first adaptation of the SoAS into another language, French. For this French version of the Sense of Agency Scale (F-SoAS), we analyzed responses from a sample of 517 native French-speakers. Our results indicate that the scale has good psychometric properties. Factor analysis confirms the same two-factor model as Tapal et al. (2017) . However, some items were removed due to insufficient loadings with factors, leading to a short version of the scale (7-item). Furthermore, we observed gender differences that are consistent with findings in the literature. Specifically, women report higher SoNA scores and lower SoPA scores than men. We conclude by discussing possible uses and future directions for the scale.

No abstract

No abstract