RezumatIntroducere: Anemia şi transfuzia reprezintă factori de risc independenţi de evoluţie nefavorabilă în cancerul colorectal. Anemia severă poate creşte agresivitatea tumorală iar transfuzia poate induce imunosupresie, promovând astfel recurenţa cancerului. Strategiile de Gestionare a Sângelui Pacientului (GSP), specifice pentru pacienţii oncologici, sunt în prezent insuficient definite şi recomandate. Obiectiv primar: Evaluarea prevalenţei anemiei şi a ratei de transfuzie perioperator la pacienţii cu neoplasm colorectal. Obiectiv secundar: Analiză subgrup pacienţi anemici versus non-anemici, cancer de colon versus cancer rectal. Metodă: Am evaluat retrospectiv datele pacienţilor oncologici chirurgicali consecutivi admişi în intervalul Ianuarie-Iunie 2017. Am selectat pacienţii cu chirurgie abdominală inferioară şi ulterior chirurgie colo-rectală. Au fost înregistrate dinamica perioperatorie a valorilor hemoglobinei (preoperator = Hb1, postoperator = Hb2, la externare = Hb3), prevalenţa şi severitatea anemiei, rata de transfuzie. Analiza statistică a utilizat testele t Student, Wilcoxon şi Chi-pătrat din programul SPSS 17.0. Rezultate: Din 1284 pacienţi evaluaţi, 546 au fost supuşi chirurgiei abdominale inferioare şi 260 chirurgiei colorectale. Vârsta medie a fost de 65.6 ± 11.1 ani, 57.7% gen masculin. Dinamica perioperatorie a hemoglobinei a fost Hb1/Hb2/Hb3=12/10.6/10.4g/dl. Prevalenţa anemiei preoperator/ postoperator/ la externare a fost

25Background. Numerous studies associate adipokines with colorectal malignancy, but few data deal with 26 patients suffering exclusively of rectal carcinoma (RC). Aims. We evaluated leptin and adiponectin levels 27 in RC patients compared to healthy population and their dynamics after surgery. Material and methods. 28 Serum leptin and adiponectin were evaluated before surgery in 59 RC consecutive patients (38 males and 29 21 females), and in age and weight matched healthy controls. Measurements were repeated at 24, 72 30 hours and 7 days after surgery. Results. Adipokine levels were higher in women. Controls had higher 31 leptin (32.±4.34 vs 9.51±1.73 ng/ml in women and 11±2.66 vs 2.54±0.39 ng/ml in men, p=0.00048 and 32 0.0032) and lower adiponectin (9±0.64 vs 11.85±1.02 µg/ml in women and 7.39±0.51 vs 8.5±0.62 µg/ml 33 in men, p=0.017 and 0.019) than RC patients. Surgery caused an increase of leptin from 5.11±0.8 to 34 18.7±2.42 ng/ml, p=6.85 x 10¨⁸, and a decrease of adiponectin from 9.71±0.58 to 7.87±0.47 µg/ml, p=1.4 35 x 10¨¹⁰ for all RC patients and returned thereafter to the initial range at 7 days. Adipokines were 36 correlated with body weight (BW). The significance of correlation persisted after surgery only in males, 37 but disappeared in females. Adipokines were not modified by tumor position, presurgical 38 chemoradiotherapy or surgical technique. Women with RC experiencing weight loss had higher 39 adiponectin than women without weight modifications (p<0.05 at all time points). Conclusions. 40 Adipokine levels of patients with RC differ from the healthy population, possibly reflecting an adaptation 41 to disease. Adipokine modifications after surgery may be related to acute surgical stress. Whether leptin 42 and adiponectin directly interact is not clear. Women have higher adipokine levels, more so after 43 significant weight loss, but the strength of their correlation with BW decreases after surgery. These data 44 suggest gender differences in the adipokine profile of RC patients which may find clinical applications. 45 46 69 neoplasia is the carcinoma located in the rectal region (rectal carcinoma, RC) which is usually not 70 accompanied by cachexia, a problem that might affect changes in adipokines. 71The aims of our study were therefore to observe differences in leptin and adiponectin levels 72 between patients suffering of RC operated in the same surgical center and healthy age, weight and 73 gender-matched controls. We also intended to follow the evolution of leptin and adiponectin after surgery 74 and at distance, at different time points. 157(low, right). Correlation was considered significant at p values lower than 0.05. NS = non-significant.

Background Numerous studies associate adipokines with colorectal malignancy, but few data deal with patients suffering exclusively of rectal carcinoma (RC). Aims We evaluated leptin and adiponectin levels in RC patients compared to healthy population and their dynamics after surgery. Material and methods Serum leptin and adiponectin were evaluated before surgery in 59 RC consecutive patients (38 males and 21 females), and in age and weight matched healthy controls. Measurements were repeated at 24, 72 hours and 7 days after surgery. Results Adipokine levels were higher in women. Controls had higher leptin (32.±4.34 vs 9.51±1.73 ng/ml in women and 11±2.66 vs 2.54±0.39 ng/ml in men, p = 0.00048 and 0.0032) and lower adiponectin (9±0.64 vs 11.85±1.02 μg/ml in women and 7.39±0.51 vs 8.5±0.62 μg/ml in men, p = 0.017 and 0.019) than RC patients. Surgery caused an increase of leptin from 5.11±0.8 to 18.7±2.42 ng/ml, p = 6.85 x 10¨ 8 , and a decrease of adiponectin from 9.71±0.58 to 7.87±0.47 μg/ml, p = 1.4 x 10¨ 10 for all RC patients and returned thereafter to the initial range at 7 days. Adipokines were correlated with body weight (BW). The significance of correlation persisted after surgery only in males, but disappeared in females. Adipokines were not modified by tumor position, presurgical chemoradiotherapy or surgical technique. Women with RC experiencing weight loss had higher adiponectin than women without weight modifications (p<0.05 at all time points). Conclusions Adipokine levels of patients with RC differ from the healthy population, possibly reflecting an adaptation to disease. Adipokine modifications after surgery may be related to acute surgical stress. Whether leptin and adiponectin directly interact is not clear. Women have higher adipokine levels, more so after significant weight loss, but the strength of their correlation with BW decreases after surgery. These data suggest gender differences in the adipokine profile of RC patients which may find clinical applications.

"Globally, 35 million people are infected with HIV, and this population is at a higher risk of developing cancer. We are reporting the case of a 44-year-old HIV-positive male patient. He smokes and drinks occasionally, but he is otherwise in good health. He was diagnosed with a visceral form of Kaposi sarcoma in January 2022 and has undergone 12 cycles of oncologic treatment with liposomal doxorubicin at our facility."