The Impact of Muscle and Adipose Tissue on Long-term Survival in Patients With Stage I to III Colorectal Cancer

2019 ◽  
Vol 62 (5) ◽  
pp. 549-560 ◽  
Author(s):  
Jessica J. Hopkins ◽  
Rebecca L. Reif ◽  
David L. Bigam ◽  
Vickie E. Baracos ◽  
Dean T. Eurich ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adipose Tissue ◽  
Stage I ◽  
Term Survival ◽  
Long Term Survival ◽  
The Impact

The impact of skeletal muscle and adipose tissue on long-term survival in patients with resectable colorectal cancer.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. 3585-3585
Author(s):  
Michael B. Sawyer ◽  
Jessica Hopkins ◽  
Rebecca Reif ◽  
David Bigam ◽  
Vickie E. Baracos ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Skeletal Muscle ◽  
Adipose Tissue ◽  
Term Survival ◽  
Long Term Survival ◽  
The Impact

scholarly journals Impact of Frailty On 5-Year Survival In Patients Older Than 70 Years Undergoing Colorectal Surgery for Cancer

2021 ◽  
Author(s):  
Manuel Artiles-Armas ◽  
Cristina Roque-Castellano ◽  
Roberto Fariña-Castro ◽  
Alicia Conde-Martel ◽  
María Asunción Acosta-Mérida ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Univariate Analysis ◽  
Cognitive Status ◽  
Tnm Stage ◽  
Term Survival ◽  
Long Term Survival ◽  
Operative Outcomes ◽  
Frail Patients ◽  
The Impact

Abstract Background: Frailty has been shown to be a good predictor of post-operative complications and death in patients undergoing gastrointestinal surgery. The aim of this study was to analyse the differences between frail and non-frail patients undergoing colorectal cancer surgery, as well as the impact of frailty on long-term survival in these patients.Methods: A cohort of 149 patients aged 70 years and older who underwent elective surgery for colorectal cancer was followed-up for at least 5 years. The sample was divided into two groups: frail and non-frail patients. The Canadian Study of Health and Aging-Clinical Frailty Scale (CSHA-CSF) was used to detect frailty. The two groups were compared with regard to demographic data, comorbidities, functional and cognitive statuses, surgical risk, surgical variables, tumour extent, and post-operative outcomes, which were mortality at 30 days, 90 days and 1 year after the procedure. Univariate and multivariate analyses were also performed to determine which of the predictive variables were related to 5-year survival.Results: Out of the 149 patients, 96 (64.4%) were men and 53 (35.6) were women, with a median age of 75 years (IQR: 72-80). According to the CSHA-CSF scale, 59 patients (39.6%) were frail, and 90 patients (60.4%) were not frail. Frail patients were significantly older and had more impaired cognitive status, worse functional status, more comorbidities, more operative mortality, and more serious complications than non-frail patients. Comorbidities, as measured by the Charlson Comorbidity Index (p=0.001); the Lawton-Brody Index (p=0.011); failure to perform an anastomosis (p=0.024); nodal involvement (p=0.005); distant metastases (p<0.001); high TNM stage (p=0.004); and anastomosis dehiscence (p=0.013) were significant univariate predictors of a poor prognosis in univariate analysis. Multivariate analysis (Cox regression) of long-term survival, with adjustment for age, frailty, comorbidities and TNM stage, showed that comorbidities (p=0.002; HR:1.30; 95% CI:1.10–1.54) and TNM stage (p=0.014; HR:2.06; 95% CI:1.16-3.67) were the only independent risk factors for survival at five years.Conclusions: Frailty is associated with poor short-term post-operative outcomes, but it does not seem to affect long-term survival in patients with colorectal cancer. Instead, comorbidities and tumour stage are good predictors of long-term survival.

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

2020 ◽  
Author(s):  
Marius Kryzauskas ◽  
Augustinas Bausys ◽  
Austeja Elzbieta Degutyte ◽  
Vilius Abeciunas ◽  
Eligijus Poskus ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Rectal Resection ◽  
Multivariable Analysis ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Male Sex ◽  
The Impact

Abstract 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.

scholarly journals Impact of frailty on 5-year survival in patients older than 70 years undergoing colorectal surgery for cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Manuel Artiles-Armas ◽  
Cristina Roque-Castellano ◽  
Roberto Fariña-Castro ◽  
Alicia Conde-Martel ◽  
María Asunción Acosta-Mérida ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Univariate Analysis ◽  
Cognitive Status ◽  
Tnm Stage ◽  
Term Survival ◽  
Long Term Survival ◽  
Operative Outcomes ◽  
Frail Patients ◽  
The Impact

Abstract Background Frailty has been shown to be a good predictor of post-operative complications and death in patients undergoing gastrointestinal surgery. The aim of this study was to analyze the differences between frail and non-frail patients undergoing colorectal cancer surgery, as well as the impact of frailty on long-term survival in these patients. Methods A cohort of 149 patients aged 70 years and older who underwent elective surgery for colorectal cancer was followed-up for at least 5 years. The sample was divided into two groups: frail and non-frail patients. The Canadian Study of Health and Aging-Clinical Frailty Scale (CSHA-CFS) was used to detect frailty. The two groups were compared with regard to demographic data, comorbidities, functional and cognitive statuses, surgical risk, surgical variables, tumor extent, and post-operative outcomes, which were mortality at 30 days, 90 days, and 1 year after the procedure. Univariate and multivariate analyses were also performed to determine which of the predictive variables were related to 5-year survival. Results Out of the 149 patients, 96 (64.4%) were men and 53 (35.6%) were women, with a median age of 75 years (IQR 72–80). According to the CSHA-CFS scale, 59 (39.6%) patients were frail, and 90 (60.4%) patients were not frail. Frail patients were significantly older and had more impaired cognitive status, worse functional status, more comorbidities, more operative mortality, and more serious complications than non-frail patients. Comorbidities, as measured by the Charlson Comorbidity Index (p = 0.001); the Lawton-Brody Index (p = 0.011); failure to perform an anastomosis (p = 0.024); nodal involvement (p = 0.005); distant metastases (p < 0.001); high TNM stage (p = 0.004); and anastomosis dehiscence (p = 0.013) were significant univariate predictors of a poor prognosis on univariate analysis. Multivariate analysis of long-term survival, with adjustment for age, frailty, comorbidities and TNM stage, showed that comorbidities (p = 0.002; HR 1.30; 95% CI 1.10–1.54) and TNM stage (p = 0.014; HR 2.06; 95% CI 1.16–3.67) were the only independent risk factors for survival at 5 years. Conclusions Frailty is associated with poor short-term post-operative outcomes, but it does not seem to affect long-term survival in older patients with colorectal cancer. Instead, comorbidities and tumor stage are good predictors of long-term survival.

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

2020 ◽  
Author(s):  
Marius Kryzauskas ◽  
Augustinas Bausys ◽  
Austeja Elzbieta Degutyte ◽  
Vilius Abeciunas ◽  
Eligijus Poskus ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Multivariate Analysis ◽  
Rectal Resection ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Male Sex ◽  
The Impact

Abstract 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 multivariate 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 multivariate 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.

The impact of length of hospitalization following surgical resection of stage I non-small cell lung cancer on long-term survival

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7584-7584
Author(s):  
A. Kilic ◽  
M. J. Schuchert ◽  
J. R. Landreneau ◽  
J. P. Landreneau ◽  
A. Oostdyk ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Hospital Stay ◽  
Surgical Resection ◽  
Tumor Stage ◽  
Stage I ◽  
Term Survival ◽  
Long Term Survival ◽  
The Impact

7584 Background: The aim of this study was to evaluate the impact of length of hospital stay (LOS) following surgical resection of stage I non-small cell lung cancer (NSCLC) on long-term survival. Methods: We reviewed the records of patients undergoing surgical resection for stage I NSCLC at our institution between 1990–2003. Patients not surviving hospitalization related to their surgery were excluded from analysis. Multivariate analysis was utilized to evaluate the impact of age, gender, tumor histology, tumor stage, LOS, and type of operation (lobar or sublobar) on long-term (>5 year) survival. As a secondary analysis, Kaplan-Meier survival curves of patients stratified according to LOS were compared using the log-rank test. Two-tailed p-values less than 0.05 were considered statistically significant. Results: A total of 730 patients underwent lobectomy (n=518) or sublobar resection during the study time period. There were 18 (2.5%) operative or in-hospital mortalities. Median LOS was 6 (range 1–81) and 7 (range 1–46) days in the lobar and sublobar cohorts, respectively. Patients with a longer hospital stay (≥14 days) had significantly worse 5- and 10-year overall survival rates as compared to those with a shorter hospitalization (lobectomy: 5-year- 60.3% vs 33.8%; 10-year-27.3% vs 8.4%; p<0.001; sublobar: 5-year-44.3% vs 11.7%; 10-year-9.9% vs 0%; p=0.006). There were 171 patients with extended clinical follow-up who had survived at least 5 years (mean follow-up = 88.1 ± 2.0 months). Multivariate analysis demonstrated that LOS predicted long-term survival independent of patient age, gender, tumor histology, tumor stage, and type of operation (p=0.013). Conclusions: LOS following surgical resection of stage I NSCLC is an independent predictor of long-term survival. These survival differences related to hospital stay may be related to underlying medical co-morbidities important to the decision making regarding therapy of patients with otherwise resectable stage I lung cancer. Prospective assessment of medical co-morbidities may be an important initiative for future treatment planning of early stage lung cancer patients. No significant financial relationships to disclose.

scholarly journals Long-Term Tacrolimus Blood Trough Level and Patient Survival in Adult Liver Transplantation

2021 ◽  
Vol 11 (2) ◽  
pp. 90
Author(s):  
Chih-Yang Hsiao ◽  
Ming-Chih Ho ◽  
Cheng-Maw Ho ◽  
Yao-Ming Wu ◽  
Po-Huang Lee ◽  
...  
Keyword(s):  
Patient Survival ◽  
Trough Level ◽  
Medical Center ◽  
Term Survival ◽  
Blood Concentrations ◽  
Long Term Survival ◽  
Tacrolimus Level ◽  
Cox's Model ◽  
The Impact

Tacrolimus is the most widely used immunosuppressant in liver transplant (LT) patients. However, the ideal long-term target level for these patients is unknown. This retrospective study aimed to investigate the impact of tacrolimus blood concentration five years after LT on long-term patient survival outcomes in adult LT recipients. Patients who underwent LT between January 2004 and July 2014 at a tertiary medical center were included in this study (n = 189). The mean tacrolimus blood concentrations of each patient during the fifth year after LT were recorded and the overall survival rate was determined. A multivariate analysis of factors associated with long-term survival was conducted using a Cox’s model. The median follow-up period was 9.63 years, and 144 patients (76.2%) underwent live donor LT. Sixteen patients died within 5 years of LT. In the Cox’s model, patients with a mean tacrolimus blood trough level of 4.6–10.2 ng/mL had significantly better long-term survival than those with a mean tacrolimus blood trough level outside this range (estimated hazard ratio = 4.76; 95% confidence interval: 1.34–16.9, p = 0.016). Therefore, a tacrolimus level no lower than 4.6 ng/mL would be recommended in adult LT patients.

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