Identification of factors predictive of postoperative morbidity and short-term mortality in older patients after colorectal carcinoma resection: A single-center retrospective study

Schreckenbach, Teresa; Zeller, Matthias Valentin; Youzouri, Hanan El; Bechstein, Wolf O.; Woeste, Guido

doi:10.1016/j.jgo.2018.05.001

Cited by 11 publications

(7 citation statements)

References 53 publications

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“…Statistical analyses were performed according to international standards and have been described by us and others before [18]; analysis was done using International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) for Windows (version 22.0; IBM, Chicago, IL, USA), BiAS (version 11, Frankfurt, Germany), and R (version 3.5.1, Vienna, Austria). Categorical variables were described in frequencies and percentages.…”

Section: Methodsmentioning

confidence: 99%

Sarcopenia as a prognostic factor for survival in patients with locally advanced gastroesophageal adenocarcinoma

et al. 2019

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Background and aimsPatients with gastric cancer often show signs of malnutrition. We sought to evaluate the influence of sarcopenia in patients with locally advanced, not metastasized, gastric or gastro-esophageal junction (GEJ) cancer undergoing curative treatment (perioperative chemotherapy and surgery) on morbidity and mortality in order to identify patients in need for nutritional intervention.Patients and methodsTwo-centre study, conducted in the Frankfurt University Clinic and Krankenhaus Nordwest (Frankfurt) as part of the University Cancer Center Frankfurt (UCT). 47/83 patients were treated in the FLOT trial (NCT01216644). Patients´ charts were reviewed for clinical data. Two consecutive CT scans were retrospectively analyzed to determine the degree of sarcopenia. Survival was calculated using the Kaplan-Meier method, multivariate analysis was performed using the Cox regression.Results60 patients (72.3%) were male and 23 (27.7%) female. 45 patients (54.2%) had GEJ type 1–3 and 38 (45.8%) gastric tumors, respectively. Sarcopenic patients were significantly older than non-sarcopenic patients (mean age 65.1 years vs. 59.5 years, p = 0.042), terminated the chemotherapy significantly earlier (50% vs. 22.6%, p = 0.037) and showed higher Clavien-Dindo scores, indicating more severe perioperative complications (score ≥3 43.3 vs. 17.0%, p = 0.019). Sarcopenic patients had a significantly shorter survival than non-sarcopenic patients (139.6 ± 19.5 [95% CI, 101.3–177.9] vs. 206.7 ± 13.8 [95% CI, 179.5–233.8] weeks, p = 0.004). Multivariate Cox regression analysis showed that, besides UICC stage, sarcopenia significantly influenced survival.ConclusionSarcopenia is present in a large proportion of patients with locally advanced gastric or GEJ cancer and significantly influences tolerability of chemotherapy, surgical complications and survival.

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Section: Methodsmentioning

confidence: 99%

Sarcopenia as a prognostic factor for survival in patients with locally advanced gastroesophageal adenocarcinoma

et al. 2019

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“…Screening of full-text articles identified a total of 45 studies that met eligibility criteria. 17–61 Search results and study selection are summarized in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Nine (8 noncardiac and 1 cardiac) reported an association between biomarker levels and our secondary outcomes of mortality and surgical or medical complications. 17,19,25,26,29,33,46,56,57 A formal meta-analysis of secondary outcomes was not possible as few studies reported these relationships and due to heterogeneity in outcome reporting. However, a narrative summary of the relationships between biomarkers and secondary outcomes investigated by each study is reported in Supplemental Digital Content 1, Appendixes 16–19, http://links.lww.com/AA/D747.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis Examining the Impact of Age on Perioperative Inflammatory Biomarkers

Patel

Zhang

Liao

et al. 2021

Anesthesia &Amp; Analgesia

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BACKGROUND: Dysregulation of immune responses to surgical stress in older patients and those with frailty may manifest as differences in inflammatory biomarkers. We conducted a systematic review and meta-analysis to examine differences in perioperative inflammatory biomarkers between older and younger patients, and between patients with and without frailty. METHODS: MEDLINE, Embase, Cochrane, and CINAHL databases were searched (Inception to June 23, 2020). Observational or experimental studies reporting the perioperative level or activity of biomarkers in surgical patients stratified by age or frailty status were included. The primary outcome was inflammatory biomarkers (grouped by window of ascertainment: pre-op; post-op: <12 hours, 12–24 hours, 1–3 days, 3 days to 1 week, and >1 week). Quality assessment was conducted using the Newcastle-Ottawa Scale. Inverse-variance, random-effects meta-analysis was conducted. RESULTS: Forty-five studies (4263 patients) were included in the review, of which 36 were pooled for meta-analysis (28 noncardiac and 8 cardiac studies). Two studies investigated frailty as the exposure, while the remaining investigated age. In noncardiac studies, older patients had higher preoperative levels of interleukin (IL)-6 and C-reactive protein (CRP), lower preoperative levels of lymphocytes, and higher postoperative levels of IL-6 (<12 hours) and CRP (12–24 hours) than younger patients. In cardiac studies, older patients had higher preoperative levels of IL-6 and CRP and higher postoperative levels of IL-6 (<12 hours and >1 week). CONCLUSIONS: Our findings demonstrate a paucity of frailty-specific studies; however, the presence of age-associated differences in the perioperative inflammatory response is consistent with age-associated states of chronic systemic inflammation and immunosenescence. Additional studies assessing frailty-specific changes in the systemic biologic response to surgery may inform the development of targeted interventions.

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“…Colorectal cancer (CRC) is one of the most common malignant tumors and the fourth leading cause of cancer-associated mortality worldwide (1). In recent years, despite improvements in precancerous screening (2–4), surgical resection (1), chemotherapy (5), radiotherapy (6) and target therapy (5), patients with CRC still exhibit poor prognosis, particularly patients at advanced stages of the disease (7). Therefore, it is crucial to identify novel therapeutic targets to improve the prognosis of CRC patients.…”

Section: Introductionmentioning

confidence: 99%

Rab23 contributes to the progression of colorectal cancer via protein kinase B and extracellular signal‑regulated kinase signaling pathways

2019

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The role of Ras-related protein Rab23 in tumors has attracted increasing attention in recent years; however, whether it can function as an oncogenic protein remains under debate, and its role in colorectal cancer (CRC) is currently unknown. In the present study, high expression of Rab23 in CRC tissues was confirmed using immunohistochemistry, and high expression of Rab23 in CRC cells (SW1116 and HT29) was confirmed using reverse transcription-polymerase chain reaction and western blot analysis. A positive association of Rab23 with tumor size and advanced clinical stage was confirmed by χ 2 analysis. In addition, the positive association of Rab23 with poor disease-free survival was confirmed by survival analysis. Cell experiments further demonstrated that overexpression of Rab23 increased the expression of the proliferation marker Ki-67 and the proliferative ability in SW1116 and HT29 cells. Molecular mechanism research revealed that the extracellular signal-regulated kinase (ERK) and protein kinase B (AKT) signaling pathways contributed to the high expression of Ki-67 and increased the proliferative ability induced by Rab23 in CRC cells. In conclusion, the study confirmed the high expression of Rab23 in CRC, and its positive association with CRC progression and poor prognosis. Furthermore, the data demonstrated that Rab23 increased the proliferation of CRC cells via the ERK and AKT signaling pathways. These results suggest that Rab23 may be used as a protein for diagnosis and prognosis prediction in patients with CRC, and is proposed to be a novel therapeutic target for improving the patient outcome.

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Identification of factors predictive of postoperative morbidity and short-term mortality in older patients after colorectal carcinoma resection: A single-center retrospective study

Cited by 11 publications

References 53 publications

Sarcopenia as a prognostic factor for survival in patients with locally advanced gastroesophageal adenocarcinoma

Sarcopenia as a prognostic factor for survival in patients with locally advanced gastroesophageal adenocarcinoma

A Systematic Review and Meta-Analysis Examining the Impact of Age on Perioperative Inflammatory Biomarkers

Rab23 contributes to the progression of colorectal cancer via protein kinase B and extracellular signal‑regulated kinase signaling pathways

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