Comparison between epidural and intravenous analgesia effects on disease-free survival after colorectal cancer surgery: a randomised multicentre controlled trial

Purpose: The impact of postoperative complications on long-term oncologic outcome after radical colorectal cancer surgery is controversial. The aim of this study was to examine the risk factors and oncologic outcomes of surgery-related postoperative complication groups.Methods: From January 2010 to December 2010, 310 patients experienced surgery-related postoperative complications after radical colorectal cancer surgery. These stage I–III patients were classified into 2 subgroups, minor (grades I, II) and major (grades III, IV) complication groups, according to extended Clavien-Dindo classification system criteria. Clinicopathologic differences between the 2 groups were analyzed to identify risk factors for major complications. The diseasefree survival rates of surgery-related postoperative complication groups were also compared.Results: Minor and major complication groups were stratified with 194 patients (62.6%) and 116 patients (37.4%), respectively. The risk factors influencing the major complication group were pathologic N category and operative method. The prognostic factors associated with disease-free survival were preoperative perforation, perineural invasion, tumor budding, and receiving neoadjuvant therapy. With a median follow-up period of 72.2 months, the 5-year disease-free survival rates were 84.4% in the minor group and 78.5% in the major group, but there was no statistical significance between the minor and major groups (P = 0.392).Conclusion: Advanced cancer and open surgery were identified as risk factors for increased surgery-related major complications after radical colorectal cancer surgery. However, severity of postoperative complications did not affect disease-free survival from colorectal cancer.

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A Preoperative Neutrophil to Lymphocyte Ratio of 3 Predicts Disease-Free Survival After Curative Elective Colorectal Cancer Surgery

Annals of Surgery ◽

10.1097/sla.0000000000000216 ◽

2014 ◽

Vol 260 (2) ◽

pp. 287-292 ◽

Cited By ~ 83

Author(s):

George Malietzis ◽

Marco Giacometti ◽

Alan Askari ◽

Subramanian Nachiappan ◽

Robin H. Kennedy ◽

...

Keyword(s):

Colorectal Cancer ◽

Disease Free Survival ◽

Cancer Surgery ◽

Neutrophil To Lymphocyte Ratio ◽

Colorectal Cancer Surgery ◽

Free Survival ◽

Lymphocyte Ratio ◽

Disease Free

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O20: PREOPERATIVE INTRAVENOUS IRON THERAPY AND SURVIVAL AFTER COLORECTAL CANCER SURGERY: LONG TERM RESULTS FROM THE INTRAVENOUS IRON IN COLORECTAL CANCER-ASSOCIATED ANAEMIA (IVICA) TRIAL

British Journal of Surgery ◽

10.1093/bjs/znab117.020 ◽

2021 ◽

Vol 108 (Supplement_1) ◽

Author(s):

EA Dickson ◽

BD Keeler ◽

O Ng ◽

A Kumar ◽

MJ Brookes ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Disease Free Survival ◽

Intravenous Iron ◽

Cancer Surgery ◽

Colorectal Cancer Surgery ◽

Free Survival ◽

Disease Free

Abstract Background Intravenous iron is now the standard treatment to correct preoperative anaemia. However, iron may promote tumour growth and progression which could influence cancer recurrence and survival. We explore the long term postoperative outcomes of patients receiving oral (OI) or intravenous iron (IVI) as part of a randomised controlled trial. Method The multicentre IVICA trial randomised anaemic colorectal cancer patients in a 1:1 fashion to receive either OI or IVI prior to their elective operation. Follow up analysis of all patients was performed and Kaplan-Meier survival estimates and Cox proportional hazard models were used to compare groups. A pooled analysis comparing patients who did/did not achieve preoperative resolution of anaemia was also undertaken. Result, Data were available for 106 of the 116 IVICA patients (OI n=55, IVI n=51). Median follow up was 61 months (IQR 38-68, [range 1-80]). Overall survival estimates at 3 and 5 years were 82%(95% CI 76-90) and 72%(58-83) respectively for OI and 75%(61-86) and 59%(45-72) for IVI, P=0.106. No significant difference in 5-year overall survival (HR 1.73, 95% CI 0.90-3.34 P=0.102) or disease-free survival (HR 1.50, 95% CI 0.83-2.73 P=0.182) was observed between groups. Those non-anaemic at operation demonstrated improved 5 year overall survival (HR 3.26 [1.01-10.58], P=0.05). Non-significant trends in improved disease-free survival (HR 2.29 [0.91-5.81], p=0.08) were observed for the non-anaemic group Conclusion Preoperative correction of anaemia confers a postoperative survival advantage following elective colorectal cancer surgery. Due to its superior efficacy intravenous iron is recommended as the treatment of choice for this anaemia. Take-home message Preoperative correction of anaemia, achieved most effectively with intravenous iron, may offer improved long term postoperative survival after colorectal cancer surgery.

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The Feasibility and Long Term Clinical Outcome of Laparoscopic Colorectal Cancer Surgery in the Rural Healthcare Setting - A Western Australian Experience

10.37191/mapsci-jasr-1(1)-001 ◽

2020 ◽

Author(s):

Abdallah Elsabag

Keyword(s):

Colorectal Cancer ◽

Local Recurrence ◽

Western Australia ◽

Disease Free Survival ◽

Cancer Surgery ◽

Colorectal Cancer Surgery ◽

Free Survival ◽

Western Australian ◽

Disease Free

Objective: Laparoscopic colorectal cancer (CRC) surgery has increasingly become the standard of care world-wide. However, the availability within the rural Western Australian setting remains heterogenous and the long term outcome is largely unknown. This study reviews our experience and 5 year outcomes in laparoscopic colorectal cancer surgery (CRC) in a major rural surgical unit in Western Australia. Materials and Methods: This is a retrospective study based in Albany Regional Hospital, Western Australia. All patients who underwent elective laparoscopic colorectal surgery for cancer by a single surgeon over a five-year period (2007- 2012) were included. All case records were reviewed. All cases had been discussed in multidisciplinary meeting and recommendations were followed in regards to staging modalities and / or neo-adjuvant and adjuvant treatments. Patients were followed up in the surgical clinic six monthly with serial CEA and a yearly CT Chest, abdomen and pelvis and colonoscopy as per guidelines, thereafter they were discharged for GP follow. The primary outcomes were local recurrence, metastatic disease, five year disease free survival, anastomotic stricture, incisional hernia and small bowel obstruction. Results: Sixty-seven patients were reviewed. Two required conversion to open (3%) and were not considered further. A total of 65 patients were included (30 male, mean age: 69 years). The most common site of tumour was at the ascending colon which comprised of 38% of all cases. The mean operating time was 161 minutes. Five year disease free survival was 97%, no Local recurrence of anastomotic strictures were detected in our study, The overall cancer related mortality was one case out of the 65 cases. Conclusions: Laparoscopic colorectal cancer surgery is safe and feasible in the rural Western Australian setting with comparable 5 year outcomes with international literature. Provided this is performed by appropriately trained general surgeons with suitable case selection.

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Anastomotic Leakage Following Colorectal Cancer Surgery: Comparison Between Conservative and Surgical Treatment

10.21203/rs.3.rs-38022/v1 ◽

2020 ◽

Author(s):

Yasuhiro Ishiyama ◽

Masaki Oneyama ◽

Yuki Tomizawa ◽

Manabu Amiki ◽

Shingo Ito ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Surgical Treatment ◽

Conservative Treatment ◽

Anastomotic Leakage ◽

Disease Free Survival ◽

Colorectal Cancer Surgery ◽

Free Survival ◽

Conservative And Surgical Treatment ◽

Disease Free

Abstract Backgrounds Anastomotic leakage following colorectal cancer is associated with significant morbidity and mortality. However, whether the choice of the treatment for anastomotic leakage may affect the oncological outcomes is under debate. We evaluated the oncological outcomes after colorectal cancer surgery for anastomotic leakage between conservative and surgical treatment. Methods We retrospectively analyzed data for patients with colorectal cancer who underwent curative colectomy from April 2010 to January 2020. Results A total 1039 patients underwent surgery colorectal cancer in our hospital. After exclusion, a total of 915 patients underwent a low anastomosis with diverting stoma for colorectal cancer of which 92 (10.0%) anastomotic leakage occurred. After stage Ⅳ and emergency surgery case were excluded, a total of 75 patients were included for the analysis. The surgical treatment group was 25 cases. The conservative treatment group was 50 cases. Early anastomotic leakage was more than in surgical treatment compared to conservative treatment (84% vs 54%, P =0.008). The 5-year overall survival rates and the 5-year disease free survival did not differ significantly between the two groups. The recurrence location of liver metastasis was more than in surgical treatment compared to conservative treatment (20% vs 2 %, P=0.02). On a multivariable analysis, anastomotic leak did not impact overall survival and disease free survival. Conclusion We found that the treatment for anastomotic leakage was not depended on increased local, distance recurrence, overall survival, and disease free survival. Our findings may help surgeons determine which AL treatment is most appropriate, when the decision is unclear.

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Correction to: The effect of pre- and post-operative physical activity on recovery after colorectal cancer surgery (PHYSSURG-C): study protocol for a randomised controlled trial

Trials ◽

10.1186/s13063-020-04979-8 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Aron Onerup ◽

Eva Angenete ◽

David Bock ◽

Mats Börjesson ◽

Monika Fagevik Olsén ◽

...

Keyword(s):

Physical Activity ◽

Colorectal Cancer ◽

Randomised Controlled Trial ◽

Study Protocol ◽

Controlled Trial ◽

Cancer Surgery ◽

Colorectal Cancer Surgery ◽

Randomised Controlled

An amendment to this paper has been published and can be accessed via the original article.

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TRIM25 regulates oxaliplatin resistance in colorectal cancer by promoting EZH2 stability

Cell Death and Disease ◽

10.1038/s41419-021-03734-4 ◽

2021 ◽

Vol 12 (5) ◽

Author(s):

Sha Zhou ◽

Jianhong Peng ◽

Liuniu Xiao ◽

Caixia Zhou ◽

Yujing Fang ◽

...

Keyword(s):

Colorectal Cancer ◽

Disease Free Survival ◽

Free Survival ◽

Epigenetic Regulator ◽

Crc Management ◽

Disease Free ◽

Resistance To Chemotherapy

AbstractResistance to chemotherapy remains the major cause of treatment failure in patients with colorectal cancer (CRC). Here, we identified TRIM25 as an epigenetic regulator of oxaliplatin (OXA) resistance in CRC. The level of TRIM25 in OXA-resistant patients who experienced recurrence during the follow-up period was significantly higher than in those who had no recurrence. Patients with high expression of TRIM25 had a significantly higher recurrence rate and worse disease-free survival than those with low TRIM25 expression. Downregulation of TRIM25 dramatically inhibited, while overexpression of TRIM25 increased, CRC cell survival after OXA treatment. In addition, TRIM25 promoted the stem cell properties of CRC cells both in vitro and in vivo. Importantly, we demonstrated that TRIM25 inhibited the binding of E3 ubiquitin ligase TRAF6 to EZH2, thus stabilizing and upregulating EZH2, and promoting OXA resistance. Our study contributes to a better understanding of OXA resistance and indicates that inhibitors against TRIM25 might be an excellent strategy for CRC management in clinical practice.

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Thymidylate synthase expression pattern, expression level and single nucleotide polymorphism are predictors for disease-free survival in patients of colorectal cancer treated with 5-fluorouracil

International Journal of Oncology ◽

10.3892/ijo.28.5.1303 ◽

2006 ◽

Author(s):

María-Encarnación Fernández-Contreras ◽

Sandra Sánchez-Prudencio ◽

José-Javier Sánchez-Hernández ◽

María-Luisa García de Paredes ◽

Javier Gisbert ◽

...

Keyword(s):

Colorectal Cancer ◽

Single Nucleotide Polymorphism ◽

Expression Pattern ◽

Thymidylate Synthase ◽

Disease Free Survival ◽

Expression Level ◽

Nucleotide Polymorphism ◽

Single Nucleotide ◽

Free Survival ◽

Disease Free

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Radiofrequency Ablation of Hepatic Metastases from Colorectal Cancer: Are Newer Generation Probes Better?

The American Surgeon ◽

10.1177/000313480607201007 ◽

2006 ◽

Vol 72 (10) ◽

pp. 875-879 ◽

Cited By ~ 8

Author(s):

Aziz Ahmad ◽

Steven L. Chen ◽

Maihgan A. Kavanagh ◽

David P. Allegra ◽

Anton J. Bilchik

Keyword(s):

Colorectal Cancer ◽

Radiofrequency Ablation ◽

First Generation ◽

Hepatic Metastases ◽

Disease Free Survival ◽

Cancer Center ◽

Free Survival ◽

Alive With Disease ◽

Disease Free

Second-generation radiofrequency ablation (RFA) probes and their successors have more power, shorter ablation times, and an increased area of ablation compared with the first-generation probes used before 2000. We examined whether the use of the newer probes has improved the clinical outcome of RFA for hepatic metastases of colorectal cancer at our tertiary cancer center. Of 160 patients who underwent RFA between 1997 and 2003, 52 had metastases confined to the liver: 21 patients underwent 46 ablations with the first-generation probes and 31 patients underwent 58 ablations with the newer probes. The two groups had similar demographic characteristics. At a median follow-up of 26.2 months, patients treated with the newer probes had a longer median disease-free survival (16 months vs 8 months, P < 0.01) and a lower rate of margin recurrence (5.2% vs 17.4%); eight patients had no evidence of disease and one patient was alive with disease. By contrast, of the 46 patients treated with the first-generation probes, 2 patients had no evidence of disease and 1 patient was alive with disease. Newer-generation probes are associated with lower rates of margin recurrence and higher rates of disease-free survival after RFA of hepatic metastases from colorectal cancer.

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