BACKGROUND: Liver metastases from colorectal cancer are an important public health problem due to the increasing incidence of colorectal cancer worldwide. Synchronous colorectal liver metastasis has been associated with worse survival, but this prognosis is controversial. OBJECTIVE: The objective of this study was to evaluate the recurrence-free survival and overall survival between groups of patients with metachronous and synchronous colorectal hepatic metastasis. METHODS: This was a retrospective analysis of medical records of patients with colorectal liver metastases seen from 2013 to 2016, divided into a metachronous and a synchronous group. The Cox regression model and the Kaplan-Meier method with log-rank test were used to compare survival between groups. RESULTS: The mean recurrence-free survival was 9.75 months and 50% at 1 year in the metachronous group and 19.73 months and 63.3% at 1 year in the synchronous group. The mean overall survival was 20.00 months and 6.2% at 3 years in the metachronous group and 30.39 months and 31.6% at 3 years in the synchronous group. Patients with metachronous hepatic metastasis presented worse overall survival in multivariate analysis. The use of biological drugs combined with chemotherapy was related to the best overall survival prognosis. CONCLUSION: Metachronous colorectal hepatic metastasis was associated with a worse prognosis for overall survival. There was no difference in recurrence-free survival between metachronous and synchronous metastases.

PURPOSE:To describe technical aspects of a new experimental model that simulates a non heart beating organ donor. METHODS:Landrace pigs were operated on and cardiac arrest was obtained by means of myocardial infarction and interruption of ventilator support. RESULTS:Mean cardiac frequency, systolic and diastolic blood pressure levels, central venous pressure, oxygen saturation and concentration of expired CO 2 dropout occurred at seven minutes after cardiac arrest. CONCLUSION:The procedure was easily reproduced and a homogeneous circulatory failure could de obtained by the end of seven minutes. The model is suitable for further studies regarding abdominal organ transplantation.Key words: Transplantation. Models, Animal. Experimental Development. Heart Arrest. Swine. RESUMO OBJETIVO:Descrever os aspectos técnicos de um novo modelo experimental que simula um doador de órgãos após a parada cardíaca. MÉTODOS:Suínos da raça Landrace foram operados e a parada cardíaca foi obtida por meio de infarto do miocárdio e interrupção do suporte ventilatório. RESULTADOS:Freqüência cardíaca, pressão arterial sistólica e diastólica, pressão venosa central, saturação de oxigênio e concentração parcial de CO 2 são consistentes com falência hemodinâmica ao final de sete minutos. CONCLUSÕES:O procedimento foi facilmente executado e uma falência circulatória pode ser obtida ao final de sete minutos. Este modelo é adequado para estudos posteriores com respeito a preservação e tranplantes de órgãos abdominais.

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PURPOSE:To evaluate the feasibility of an experimental model of donors after cardiac death in remote ischemic preconditioning studies. METHODS:Twelve Landrace pigs were used as organ donors. They underwent cardiac arrest by coronary en block suture and interruption of ventilatory support. Haemodynamic data regarding the donor surgical protocol were evaluated. Studies variables included mean heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, central venous pressure and oxygen saturation and the time to death. RESULTS:Haemodynamic parameter indicated that the circulatory failure occurred after nine minutes of en block coronary suture and respiratory support interruption. The circulatory collapse occurred evenly across all groups. The heart rate and central venous pressure were statistically different between groups (p=0.023 and p=0.04), respectively. The remote preconditioning resulted in delayed time of death. CONCLUSIONS:The model is feasible, and was easily reproduced. The ischemic remote preconditioning tends to a slight increase in circulatory failure time.

SEM RESUMO

Myeloid-derived suppressor cells (MDSC) have been recently observed in the liver parenchyma of tumor-bearing animals. Kupffer cells represent the first line of defense against tumor cells in the liver. The present study investigates the function of various MDSC subsets and their interaction with Kupffer cells.RIL-175 hepatocellular carcinoma cells were injected into the liver of C57BL/6 mice. Three MDSC subsets were sorted. Their suppressive activities were assessed against T cells and primary isolated Kupffer cells.On day 21, MDSC increased in the spleen and in the underlying liver parenchyma of HCC-bearing mice (vs sham-operated animals, p < 0.02). Three CD11b + cell populations were identified and sorted. They expressed different level of MDSC-specific surface markers: Ly6G high cells, Gr1 high cells and Ly6C low cells, and might be considered as MDSC as they suppressed antigen-specific T cell proliferation. The coculture of primary isolated Kupffer cells with the three MDSC subsets showed a decrease in CCL2 and IL-18 secretion and an increase in IL-10 secretion (p < 0.05). Kupffer cells in coculture had also an increased expression of PD-L1 (p < 0.01).These data demonstrate the existence of three MDSC subsets in HCC-bearing animals. These cells alter Kupffer cell function, and may decrease the migration and activation of anti-cancer effector cells in the liver.

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Bismuth type 3 was the commonest ( 14) type of injury/ stricture followed by type 2 (3) and type 1 (2). There was 1 mortality following surgery due to bile leak followed by severe sepsis. Remaining 18 patients had excellent postoperative outcome without significant morbid.