Does Emergency Surgery Affect Resectability of Colorectal Cancer ?

Pavlidis, Theodosios; Marakis, Georgios; Ballas, Konstantinos; Rafailidis, S.; Psarras, Kyriakos; Pissas, Dimitrios; Sakantamis, Athanasios K.

doi:10.1080/00015458.2008.11680207

Cited by 17 publications

(18 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As previously denoted [23], the frequency of emergency surgery was only 8.3% which is lower than the commonly reported frequency of approximately 25% [49,50], which may reflect a higher awareness of CRC among study participants. On the other hand, the distribution of clinical stages at diagnosis is in line with the expected [23,25].…”

Section: Discussionmentioning

confidence: 55%

Sex differences in the prognostic significance of KRAS codons 12 and 13, and BRAF mutations in colorectal cancer: a cohort study

et al. 2013

View full text Add to dashboard Cite

BackgroundActivating KRAS and BRAF mutations predict unresponsiveness to EGFR-targeting therapies in colorectal cancer (CRC), but their prognostic value needs further validation. In this study, we investigated the impact of KRAS codons 12 and 13, and BRAF mutations on survival from CRC, overall and stratified by sex, in a large prospective cohort study.MethodsKRAS codons 12 and 13, and BRAF mutations were analysed by pyrosequencing of tumours from 525 and 524 incident CRC cases in The Malmö Diet and Cancer Study. Associations with cancer-specific survival (CSS) were explored by Cox proportional hazards regression, unadjusted and adjusted for age, TNM stage, differentiation grade, vascular invasion and microsatellite instability (MSI) status.ResultsKRAS and BRAF mutations were mutually exclusive. KRAS mutations were found in 191/ 525 (36.4%) cases, 82.2% of these mutations were in codon 12, 17.3% were in codon 13, and 0.5% cases had mutations in both codons. BRAF mutations were found in 78/524 (14.9%) cases. Overall, mutation in KRAS codon 13, but not codon 12, was associated with a significantly reduced CSS in unadjusted, but not in adjusted analysis, and BRAF mutation did not significantly affect survival. However, in microsatellite stable (MSS), but not in MSI tumours, an adverse prognostic impact of BRAF mutation was observed in unadjusted, but not in adjusted analysis. While KRAS mutation status was not significantly associated with sex, BRAF mutations were more common in women. BRAF mutation was not prognostic in women; but in men, BRAF mutation was associated with a significantly reduced CSS in overall adjusted analysis (HR = 3.50; 95% CI = 1.41–8.70), but not in unadjusted analysis. In men with MSS tumours, BRAF mutation was an independent factor of poor prognosis (HR = 4.91; 95% CI = 1.99–12.12). KRAS codon 13 mutation was associated with a significantly reduced CSS in women, but not in men in unadjusted, but not in adjusted analysis.ConclusionsResults from this cohort study demonstrate sex-related differences in the prognostic value of BRAF mutations in colorectal cancer, being particularly evident in men. These findings are novel and merit further validation.

show abstract

Section: Discussionmentioning

confidence: 55%

Sex differences in the prognostic significance of KRAS codons 12 and 13, and BRAF mutations in colorectal cancer: a cohort study

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Estima-se que desses, 93 casos foram operados por via laparoscópica. Considerando-se que em média até 95% (70-98%) 16,18,19,22,23 das neoplasias colorretais são ressecáveis cirurgicamente de forma eletiva, é possível calcular-se um valor aproximado de 14,4% das abordagens das neoplasias colorretais sendo realizada por via laparoscópica. Esse valor é semelhante aos relatados em estudos populacionais internacionais entre 2,4% a 19,5% 16,20,21 .…”

Section: Discussionunclassified

“…Esse valor é semelhante aos relatados em estudos populacionais internacionais entre 2,4% a 19,5% 16,20,21 . Deve-se, entretanto, salientar que 15-20% das neoplasias se manifestam com quadro abdominal agudo, sendo considerada contra-indicada a ressecção laparoscópica 18,19 .…”

Section: Discussionunclassified

Resultados do registro de cirurgias colorretais videolaparoscópicas realizadas no Estado de Minas Gerais - Brasil de 1996 a 2009

Queiroz

Côrtes²,

Neto³

et al. 2010

Rev bras. colo-proctol.

View full text Add to dashboard Cite

INTRODUÇÃO: A partir de 1991, a videolaparoscopia começou a ser considerada no tratamento de doenças colorretais. O aprimoramento da técnica cirúrgica associado aos benefícios encontrados em diversos estudos publicados levou a modificações nas perspectivas da videolaparoscopia. A partir da publicação do estudo COST as ressecções oncológicas laparoscópicas foram reconhecidas como alternativa viável, com resultados semelhantes à cirurgia convencional. PACIENTES E MÉTODOS: Realizou-se pesquisa através de formulário específico e consulta a prontuários dos principais serviços de coloproctologia de Belo Horizonte. Avaliando-se sexo, idade, indicação cirúrgica, procedimento realizado, técnica laparoscópica, complicações, conversão, estadiamento e recidiva (no caso de neoplasias). RESULTADOS: Foram levantados dados sobre 503 cirurgias colorretais laparoscópicas: 347 (68,9%) em mulheres e 156 (31,1%) homens. A técnica cirúrgica foi totalmente laparoscópica em 137 casos, vídeo-assistida 245 casos. O procedimento mais realizado foi a retossigmoidectomia (41,1%), seguido pela colectomia direita (12,5%), colectomia esquerda (6,9%). Doenças benignas foram responsáveis por 259 (51,5%) casos, destes as principais indicações cirúrgicas foram endometriose 126 (48,6%), pólipos 40 (15,4%), doença diverticular 30 (11,6%). Das 240 cirurgias realizadas por doenças malignas as mais frequentes foram retossigmoidectomia 102 (42,5%), colectomia direita 46 (19,1%), colectomia esquerda 18 (7,5%), amputação abdominoperineal 18 (7,5%). Houve 54 conversões (10.7%) dos casos, 12,9% (31/240) nos casos de neoplasias, 8,5% (22/259) nos de doenças benignas. Complicações sistêmicas ou cirúrgicas ocorreram em 31 (6,1%) e 56 (11,1%) casos, respectivamente. Foram registrados onze (2,18%) óbitos nos primeiros 30 dias após a cirurgia. CONCLUSÃO: O estudo atual foi o primeiro levantamento da implantação de cirurgias colorretais laparoscópicas realizado de forma multicêntrica em Minas Gerais. Os dados levantados são consistentes com registros nacionais de videocirurgia colorretal, mostrando a eficiência do método de aprendizado com realização de cirurgias com tutor. Além disso, que pequena parte das cirurgias colorretais são realizadas por via laparoscópica no estado, restritos apenas a centros especializados, sobrecarregando esses serviços e limitando o acesso para a população.

show abstract

“…Levels of colorectal EP reported vary: Greece 12% Australia 16% Sweden 17% Canada 24% Norway 25% (Mitchell et al , 2007; Pavlidis et al , 2008; Wong et al , 2008; Sjo et al , 2009; Gunnarsson et al , 2011). These studies tend to be based at single centres, comparatively small (<2000 patients), and based on data stretching back to the 1990s or 1980s.…”

mentioning

confidence: 99%

Emergency presentation of cancer and short-term mortality

McPhail¹,

Elliss‐Brookes²,

Shelton³

et al. 2013

Br J Cancer

179

177

View full text Add to dashboard Cite

Background:The short-term survival following a cancer diagnosis in England is lower than that in comparable countries, with the difference in excess mortality primarily occurring in the months immediately after diagnosis. We assess the impact of emergency presentation (EP) on the excess mortality in England over the course of the year following diagnosis.Methods:All colorectal and cervical cancers presenting in England and all breast, lung, and prostate cancers in the East of England in 2006–2008 are included. The variation in the likelihood of EP with age, stage, sex, co-morbidity, and income deprivation is modelled. The excess mortality over 0–1, 1–3, 3–6, and 6–12 months after diagnosis and its dependence on these case-mix factors and presentation route is then examined.Results:More advanced stage and older age are predictive of EP, as to a lesser extent are co-morbidity, higher income deprivation, and female sex. In the first month after diagnosis, we observe case-mix-adjusted excess mortality rate ratios of 7.5 (cervical), 5.9 (colorectal), 11.7 (breast ), 4.0 (lung), and 20.8 (prostate) for EP compared with non-EP.Conclusion:Individuals who present as an emergency experience high short-term mortality in all cancer types examined compared with non-EPs. This is partly a case-mix effect but EP remains predictive of short-term mortality even when age, stage, and co-morbidity are accounted for.

show abstract

Does Emergency Surgery Affect Resectability of Colorectal Cancer ?

Abstract: Emergency surgery for colorectal carcinoma is related to lower resectability and to higher--but acceptable--postoperative morbidity and mortality rates, when compared with elective surgical management.

Cited by 17 publications

References 19 publications

Sex differences in the prognostic significance of KRAS codons 12 and 13, and BRAF mutations in colorectal cancer: a cohort study

Sex differences in the prognostic significance of KRAS codons 12 and 13, and BRAF mutations in colorectal cancer: a cohort study

Resultados do registro de cirurgias colorretais videolaparoscópicas realizadas no Estado de Minas Gerais - Brasil de 1996 a 2009

Emergency presentation of cancer and short-term mortality

Contact Info

Product

Resources

About