P-P41 Systematic review of Sarcopenia in Chronic Pancreatitis: prevalence, impact on surgical outcomes and survival

Abstract Background Chronic pancreatitis(CP) is characterised by progressive inflammatory changes to the pancreas, leading to loss of endocrine and exocrine function. Emerging literature suggests sarcopenia may adversely affect outcomes for chronic pancreatitis patients. This systematic review examines the evidence surrounding the impact of sarcopenia on patients with CP. Methods A systematic literature search of PUBMED, MEDLINE and EMBASE databases identified articles describing body composition assessment in patients with CP. Data collected included definitions of sarcopenia, assessment methodology, baseline demographics, surgery related data and short- and long-term outcomes. Results 9 studies, including 977 patients and a sarcopenia prevalence of 32.3% were included. Alcohol was the predominant aetiology. There was significant heterogeneity in definitions of sarcopenia used. CT was the main modality to assess for sarcopenia in 7 papers, MRI in 2 papers and clinical measurements in 2 papers. 2 papers included patients undergoing total pancreatectomy and Islet cell transplantation. None of the studies found a significant increase in complications with sarcopenia. 1 Year mortality in outpatients from one study of patients with CP was 16% in sarcopenic patients versus 3% (HR:6.69(95%CI:1.79–24.9),p<0.001). Conclusions Sarcopenia is prevalent in patients with CP and has adverse impact on short- and long-term survival.

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Efficacy of Surgery for the Treatment of Gastric Cancer Liver Metastases: A Systematic Review of the Literature and Meta-Analysis of Prognostic Factors

Journal of Clinical Medicine ◽

10.3390/jcm10051141 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1141

Author(s):

Gianpaolo Marte ◽

Andrea Tufo ◽

Francesca Steccanella ◽

Ester Marra ◽

Piera Federico ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Prognostic Factors ◽

Liver Metastases ◽

Meta Analysis ◽

Multidisciplinary Treatment ◽

Review Of The Literature ◽

Term Survival ◽

The Impact

Background: In the last 10 years, the management of patients with gastric cancer liver metastases (GCLM) has changed from chemotherapy alone, towards a multidisciplinary treatment with liver surgery playing a leading role. The aim of this systematic review and meta-analysis is to assess the efficacy of hepatectomy for GCLM and to analyze the impact of related prognostic factors on long-term outcomes. Methods: The databases PubMed (Medline), EMBASE, and Google Scholar were searched for relevant articles from January 2010 to September 2020. We included prospective and retrospective studies that reported the outcomes after hepatectomy for GCLM. A systematic review of the literature and meta-analysis of prognostic factors was performed. Results: We included 40 studies, including 1573 participants who underwent hepatic resection for GCLM. Post-operative morbidity and 30-day mortality rates were 24.7% and 1.6%, respectively. One-year, 3-years, and 5-years overall survival (OS) were 72%, 37%, and 26%, respectively. The 1-year, 3-years, and 5-years disease-free survival (DFS) were 44%, 24%, and 22%, respectively. Well-moderately differentiated tumors, pT1–2 and pN0–1 adenocarcinoma, R0 resection, the presence of solitary metastasis, unilobar metastases, metachronous metastasis, and chemotherapy were all strongly positively associated to better OS and DFS. Conclusion: In the present study, we demonstrated that hepatectomy for GCLM is feasible and provides benefits in terms of long-term survival. Identification of patient subgroups that could benefit from surgical treatment is mandatory in a multidisciplinary setting.

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Short- and long-term survival after isolated coronary artery bypass grafting, the impact of gender and age

Scandinavian Cardiovascular Journal ◽

10.1080/14017431.2019.1646430 ◽

2019 ◽

Vol 53 (6) ◽

pp. 342-347

Author(s):

A. Nuru ◽

J. A. H. Weltzien ◽

L. Sandvik ◽

T. Tønnessen ◽

J. L. Bjørnstad

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Term Survival ◽

Gender And Age ◽

Short And Long Term ◽

The Impact

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723 TWO- VS. THREE-FIELD LYMPHADENECTOMY FOR ESOPHAGEAL CANCER. A SYSTEMATIC REVIEW AND META-ANALYSIS OF SHORT- AND LONG-TERM OUTCOMES.

Diseases of the Esophagus ◽

10.1093/dote/doab052.723 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Letícia Nogueira Datrino ◽

Clara Lucato Santos ◽

Guilherme Tavares ◽

Luca Schiliró Tristão ◽

Maria Carolina Andrade Serafim ◽

...

Keyword(s):

Systematic Review ◽

Esophageal Cancer ◽

Meta Analysis ◽

Operation Time ◽

Extended Lymphadenectomy ◽

Long Term Outcomes ◽

Term Survival ◽

Long Term Survival ◽

Short And Long Term

Abstract Nowadays, there is still no consensus about the benefits of adding neck lymphadenectomy to the traditional two-fields esophagectomy. An extended lymphadenectomy could potentially increase operation time and the risks for postoperative complications. However, extended lymphadenectomy allows resection of cervical nodes at risk for metastases, potentially increasing long-term survival rates. This study aims to estimate whether cervical prophylactic lymphadenectomy for esophageal cancer influences short- and long-term outcomes through a systematic review of literature and meta-analysis. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, and Lilacs (BVS). The inclusion criteria were: (1) studies that compare two-field vs. three-field esophagectomy; (2) adults (>18 years); (3) articles that analyze short- or long-term outcomes; and (4) clinical trials or cohort studies. The results were summarized by forest plots, with effect size (ES) or risk difference (RD) and 95% CI. Results Twenty-five articles were selected, comprising 8,954 patients. Three-field lymphadenectomy was associated to higher operation time (ES: -1.51; 95%CI -1.84, −1.18) and higher blood loss (ES: -0.24; 95%CI: −0.37, −0.11). Also, neck lymphadenectomy inputs additional risk for pulmonary complications (RD: 0.03; 95%CI: 0.01, 0.05). No difference was noted for morbidity (RD: 0.01; 95%CI: −0.01, 0.03); leak (−0.02; 95%CI: −0.07, 0.03); postoperative mortality (RD: 0.00; 95%CI: −0.00, 0.01), and hospital stay (ES: -0.05; 95%CI -0.20, 0.10). Three-field lymphadenectomy allowed higher number of retrieved lymph nodes (MD: -1.51; 95%CI -1.84, −1.18), but did not increase the overall survival (HR: 1.11; 95%CI: 0.96, 1.26). Conclusion Prophylactic neck lymphadenectomy for esophageal cancer should be performed with caution once it is associated with poorer short-term outcomes compared to traditional two-field lymphadenectomy and does not improve long-term survival. Future esophageal cancer studies should determine the subgroup of patients who could benefit from prophylactic neck lymphadenectomy in long-term outcomes.

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The impact of anastomotic leakage on recurrence and long-term survival in patients with colonic cancer: A systematic review and meta-analysis

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2019.10.038 ◽

2020 ◽

Vol 46 (3) ◽

pp. 439-447 ◽

Cited By ~ 4

Author(s):

Khadra Bashir Mohamed ◽

Christine Haangard Hansen ◽

Peter-Martin Krarup ◽

Tina Fransgård ◽

Michael Tvilling Madsen ◽

...

Keyword(s):

Systematic Review ◽

Anastomotic Leakage ◽

Colonic Cancer ◽

Meta Analysis ◽

Term Survival ◽

Long Term Survival ◽

The Impact

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Prophylactic Thoracic Duct Obstruction During Esophagectomy: What Is the Impact on Perioperative Risks and Long-term Survival? a Systematic Review and Meta-analysis

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2021.08.499 ◽

2021 ◽

Vol 233 (5) ◽

pp. e185

Author(s):

Clara Lucato dos Santos ◽

Laura Lucato dos Santos ◽

Leticia N. Datrino ◽

Guilherme Tavares ◽

Luca S. Tristão ◽

...

Keyword(s):

Systematic Review ◽

Thoracic Duct ◽

Meta Analysis ◽

Term Survival ◽

Long Term Survival ◽

Duct Obstruction ◽

Perioperative Risks ◽

The Impact

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Impact of Different Aortic Entry Tear Sites on Early Outcomes and Long-Term Survival in Patients with Stanford A Acute Aortic Dissection

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0038-1649511 ◽

2018 ◽

Vol 67 (05) ◽

pp. 363-371

Author(s):

Julia Merkle ◽

Anton Sabashnikov ◽

Antje Christin Deppe ◽

Saskia Weber ◽

Navid Mader ◽

...

Keyword(s):

Aortic Dissection ◽

Aortic Arch ◽

Acute Aortic Dissection ◽

Term Survival ◽

Long Term Survival ◽

Kaplan Meier ◽

Cerebrovascular Events ◽

Short And Long Term ◽

The Impact

Background Stanford A acute aortic dissection (AAD) is a life-threatening emergency. The aim of this study was to compare the impact of three different aortic entry tear sites on early outcomes and long-term survival of patients with Stanford A AAD. Methods From January 2006 to April 2015, a total of 240 consecutive patients with diagnosed Stanford A AAD underwent emergent, isolated surgical aortic repair in our center. Patients were divided into three groups comprising isolated ascending aorta, proximal aortic arch, and distal aortic arch entry tear site and were followed up for up to 9 years. Results Thirty-day mortality as well as major cerebrovascular events were significantly different between the three groups (p = 0.007 and p = 0.048, respectively). Overall cumulative short- and long-term survival of all patients revealed significant differences (Log-Rank p = 0.002), whereas survival of all patients free from major cerebrovascular events was similar (Log-Rank p = 0.780). Subgroup analysis of short- and long-term survival of patients showed significant differences in terms of men (Log-Rank p = 0.043), women (Log-Rank p = 0.004), patients over 65 years of age (Log-Rank p = 0.007), and hypertensive patients (Log-Rank p = 0.003). Kaplan–Meier survival estimation plots significantly showed poorest survival for distal aortic arch entry tear site group. Conclusion The location of the primary entry tear in patients with Stanford A AAD significantly influences early outcomes, short- and long-term survival of patients, whereas survival of patients free from major cerebrovascular events showed similar results among the three groups. Distal aortic entry tear site showed poorest outcomes and survival.

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