Even with multidisciplinary team approach, the prognosis of Oesophageal Cancer (EC) has not significantly changed. Studies are required to explore the other prognostic factors, which might alter the outcome. Our study aims at correlating the oesophageal tumour length with stage of the disease and analyse the clinicopathological features. METHODS150 patients with oesophageal carcinoma (ca) who underwent curative surgery without neoadjuvant chemotherapy and/or radiotherapy are included in the study. Formalin fixed oesophageal tumour length was measured. Tumour length was analysed with respect to overall stage, T stage and N stage of the disease. Clinicopathological characteristics were studied. RESULTSFrom our study correlating tumour length with stage and lymph node involvement, it is observed that there is no linear association with stage of the disease. Squamous cell carcinoma is the predominant histology and lower third was the site most affected. Even though most of the patients still present at an advanced stage, patients with adenocarcinoma presented earlier than squamous cell carcinoma patients. CONCLUSIONAs there is no proportionate increase in stage of disease with increase in length of tumour, oesophageal tumour length may not be an appropriate prognostic factor. Further well planned studies might bring more evidence on this aspect with respect to impact of tumour length on survival.
There is limited data available in the literature about the hyperglycaemic response in cancer patients in the postoperative period. Hyperglycaemia resulting from insulin resistance is common in critically ill patients including those who have not previously been diagnosed with diabetes. We tried to analyse the glycaemic response in different cancer patients in the postoperative period, so that this information can be analysed to look for any correlation between the glycaemic response and the surgical outcome, in particular cancer patients. Prospectively, the postoperative blood glucose level was measured at different intervals. Hyperglycaemic response was more at 6 th hour and gradually declined over next 72 hours. Hyperglycaemic response was more in carcinoma oesophagus patients and least in thyroid patients. The stress of surgery itself results in metabolic perturbations that alter glucose homeostasis. Persistent hyperglycaemia is a risk factor for endothelial dysfunction, impaired phagocytosis and immunity, oxidative stress, abnormal lipid metabolism, decreased vascular contractility, increased platelet adhesiveness and increased C-reactive protein levels, consequently resulting in cardiovascular morbidity, postoperative sepsis and impaired wound healing. Patients with cancer respond differently to stress and this knowledge might help in the future to develop strategies to reduce and treat during the postoperative period. OBJECTIVETo study the pattern of glycaemic variation in patients with different Cancers during the postoperative period.
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