Does testosterone prevent early postoperativecomplications after gastrointestinal surgery?

Sah, Birendra Kumar; Chen, Mingmin; Peng, Yi-Bing; Feng, Xiaojing; Yan, Min; Liu, Bingya; Fan, Qing; Zhu, Zhenggang

doi:10.3748/wjg.15.5604

Cited by 9 publications

(6 citation statements)

References 24 publications

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“…Male gender is thought to increase the AL rate because of more technically demanding surgery in the narrow and deeper pelvis of men [13]. There is a possibility that hormonal functions may impact anastomotic healing as well [15,16]. The advanced stage of tumor also makes surgery more technically challenging, and it was confirmed as another risk factor for AL by our study.…”

Section: Discussionsupporting

confidence: 60%

Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

et al. 2020

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Background: Anastomotic leakage (AL) significantly impairs short-term outcomes. The impact on the long-term outcomes remains unclear. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer. Methods: Nine-hundred patients with left-sided colorectal carcinoma who underwent sigmoid or rectal resection were enrolled in the study. Risk factors for AL after sigmoid or rectal resection were identified, and long-term outcomes of patients with and without AL were compared. Results: AL rates following sigmoid and rectal resection were 5.1% and 10.7%, respectively. Higher ASA score (III-IV; OR = 10.54, p = 0.007) was associated with AL in patients undergoing sigmoid surgery on multivariable analysis. Male sex (OR = 2.40, p = 0.004), CCI score > 5 (OR = 1.72, p = 0.025), and T3/T4 stage tumors (OR = 2.25, p = 0.017) were risk factors for AL after rectal resection on multivariable analysis. AL impaired disease-free and overall survival in patients undergoing sigmoid (p = 0.009 and p = 0.001) and rectal (p = 0.003 and p = 0.014) surgery. Conclusion: ASA score of III-IV is an independent risk factor for AL after sigmoid surgery, and male sex, higher CCI score, and advanced T stage are risk factors for AL after rectal surgery. AL impairs the long-term survival in patients undergoing left-sided colorectal surgery.

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Section: Discussionsupporting

confidence: 60%

Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

et al. 2020

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“…Additionally, Progesterone Receptor (PR) expression is significantly upregulated in GCa tissue [ 12 ], although serum progesterone levels do not correlated with incidences of GCa [ 13 ]. Moreover, serum testosterone levels are significantly decreased in incidences of recurring GCa [ 14 ], and low testosterone levels are correlated with post-surgery complications [ 15 ]. The conflicting results between serum levels of sex hormones and receptor expression levels implicate a possible role of intrinsic de novo synthesis of sex steroids in GCa.…”

Section: Introductionmentioning

confidence: 99%

Cholesterol import and steroidogenesis are biosignatures for gastric cancer patient survival

et al. 2016

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Androgens, estrogens, progesterone and related signals are reported to be involved in the pathology of gastric cancer. However, varied conclusions exist based on serum hormone levels, receptor expressions, and in vitro or in vivo studies. This report used a web-based gene survival analyzer to evaluate biochemical processes, including cholesterol importing via lipoprotein/receptors (L/R route), steroidogenic enzymes, and steroid receptors, in gastric cancer patients prognosis. The sex hormone receptors (androgen receptor, progesterone receptor, and estrogen receptor ESR1 or ESR2), L/R route (low/high-density lipoprotein receptors, LDLR/LRP6/SR-B1 and lipoprotein lipase, LPL) and steroidogenic enzymes (CYP11A1, HSD3B1, CYP17, HSD17B1, HSD3B1, CYP19A1 and SRD5A1) were associated with 5-year survival of gastric cancer patients. The AR, PR, ESR1 and ESR2 are progression promoters, as are the L/R route LDLR, LRP6, SR-B1 and LPL. It was found that CYP11A1, HSD3B1, CYP17, HSD17B1 and CYP19A1 promote progression, but dihydrotestosterone (DHT) converting enzyme SRD5A1 suppresses progression. Analyzing steroidogenic lipidome with a hazard ratio score algorithm found that CYP19A1 is the progression confounder in surgery, HER2 positive or negative patients. Finally, in the other patient cohort from TCGA, CYP19A1 was expressed higher in the tumor compared to that in normal counterparts, and also promoted progression. Lastly, exemestrane (type II aromatase inhibitor) dramatically suppress GCa cell growth in pharmacological tolerable doses in vitro. This work depicts a route-specific outside-in delivery of cholesterol to promote disease progression, implicating a host-to-tumor macroenvironmental regulation. The result indicating lipoprotein-mediated cholesterol entry and steroidogenesis are GCa progression biosignatures. And the exemestrane clinical trial in GCa patients of unmet medical needs is suggested.

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“…13 There is a possibility that hormonal functions may impact anastomotic healing as well. 15,16 The advanced stage of tumor also makes surgery more technically challenging and it was con rmed as another risk factor for AL by our study. Interestingly, we did not nd a higher AL rate in patients receiving low anastomosis.…”

Section: Discussionmentioning

confidence: 56%

Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

Kryžauskas

Baušys

Degutyte

et al. 2020

Preprint

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Background: Anastomotic leakage (AL) significantly impairs short-term outcomes. The impact on the long-term outcomes remains unclear. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer.Methods: Nine-hundred patients with left-sided colorectal carcinoma who underwent sigmoid or rectal resection were enrolled in the study. Risk factors for AL after sigmoid or rectal resection were identified and long-term outcomes of patients with and without AL were compared.Results: AL rates following sigmoid and rectal resection were 5.1% and 10.7%, respectively. Higher ASA score (III-IV; OR=10.54, p=0.007) was associated with AL in patients undergoing sigmoid surgery on multivariable analysis. Male sex (OR=2.40, p=0.004), CCI score >5 (OR=1.72, p=0.025) and T3/T4 stage tumors (OR=2.25, p=0.017) were risk factors for AL after rectal resection on multivariable analysis. AL impaired disease-free and overall survival in patients undergoing sigmoid (p=0.009 and p=0.001) and rectal (p=0.003 and p=0.014) surgery.Conclusion: ASA score of III-IV is an independent risk factor for AL after sigmoid surgery and male sex, higher CCI score, and advanced T stage are risk factors for AL after rectal surgery. AL impairs the long-term survival in patients undergoing left-sided colorectal surgery.

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Does testosterone prevent early postoperativecomplications after gastrointestinal surgery?

Cited by 9 publications

References 24 publications

Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

Cholesterol import and steroidogenesis are biosignatures for gastric cancer patient survival

Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

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