Chemotherapy and Abdominal Wall Closure Technique Increase the Probability of Postoperative Ventral Incisional Hernia in Patients With Colon Cancer

2021 ◽  
pp. 000313482110111
Author(s):  
David A. Santos ◽  
Liangliang Zhang ◽  
Kim-Anh Do ◽  
Brian K. Bednarski ◽  
Celia Robinson Ledet ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Suture Technique ◽  
Abdominal Wall Closure ◽  
Clinical Predictors ◽  
Closure Technique ◽  
Ventral Incisional Hernia

Background Chemotherapy is associated with postoperative ventral incisional hernia (PVIH) after right hemicolectomy (RHC) for colon cancer, and abdominal wall closure technique may affect PVIH. We sought to identify clinical predictors of PVIH. Methods We retrospectively analyzed patients who underwent RHC for colon cancer from 2008-2018 and later developed PVIH. Time to PVIH was analyzed with Kaplan-Meier analysis, clinical predictors were identified with multivariable Cox proportional hazards modeling, and the probability of PVIH given chemotherapy and the suture technique was estimated with Bayesian analysis. Results We identified 399 patients (209 no adjuvant chemotherapy and 190 adjuvant chemotherapy), with an overall PVIH rate of 38%. The 5-year PVIH rate was 55% for adjuvant chemotherapy, compared with 38% for none (log-rank P < .05). Adjuvant chemotherapy (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.18-2.31, P < .01), age (HR .99, 95% CI .97-1.00, P < .01), body mass index (HR 1.02, 95% CI 1.00-1.04, P < .01), and neoadjuvant chemotherapy (HR 1.92, 95% CI 1.21-3.00, P < .01) were independently associated with PVIH. Postoperative ventral incisional hernia was more common overall in patients who received adjuvant chemotherapy (46% compared with 30%, P < .01). In patients who received adjuvant chemotherapy, the probability of PVIH for incision closure with #1 running looped polydioxanone was 42%, compared with 59% for incision closure with #0 single interrupted polyglactin 910. Discussion Exposure to chemotherapy increases the probability of PVIH after RHC, and non–short stitch incision closure further increases this probability, more so than age or body mass index. The suture technique deserves further study as a modifiable factor in this high-risk population.

Novel method for delayed primary closure and incisional hernia prevention in open abdomen: COmbined and MOdified Definitive Abdominal wall closure (COMODA)

Hernia ◽  
2019 ◽  
Vol 24 (2) ◽  
pp. 395-401 ◽  
Author(s):  
R. Villalobos Mori ◽  
Y. Maestre González ◽  
Mª Mias Carballal ◽  
C. Gas Ruiz ◽  
G. Protti Ruiz ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Abdominal Wall ◽  
Primary Closure ◽  
Open Abdomen ◽  
Abdominal Wall Closure ◽  
Delayed Primary Closure ◽  
Hernia Prevention ◽  
Novel Method

scholarly journals Body mass index at diagnosis and survival among colon cancer patients enrolled in clinical trials of adjuvant chemotherapy

Cancer ◽  
2013 ◽  
Vol 119 (8) ◽  
pp. 1528-1536 ◽  
Author(s):  
Frank A. Sinicrope ◽  
Nathan R. Foster ◽  
Greg Yothers ◽  
Al Benson ◽  
Jean Francois Seitz ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Colon Cancer ◽  
Clinical Trials ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Body Mass

Diabetes and Body Mass Index Are Associated with Neuropathy and Prognosis in Colon Cancer Patients Treated with Capecitabine and Oxaliplatin Adjuvant Chemotherapy

Oncology ◽  
2016 ◽  
Vol 90 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Alessandro Ottaiano ◽  
Anna Nappi ◽  
Salvatore Tafuto ◽  
Guglielmo Nasti ◽  
Chiara De Divitiis ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Body Mass

scholarly journals Impact of Body Mass Index and Weight Change After Treatment on Cancer Recurrence and Survival in Patients With Stage III Colon Cancer: Findings From Cancer and Leukemia Group B 89803

2008 ◽  
Vol 26 (25) ◽  
pp. 4109-4115 ◽  
Author(s):  
Jeffrey A. Meyerhardt ◽  
Donna Niedzwiecki ◽  
Donna Hollis ◽  
Leonard B. Saltz ◽  
Robert J. Mayer ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Body Mass ◽  
Weight Change ◽  
Cancer Recurrence ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Chemotherapy Patients ◽  
Risk Of Cancer

Purpose Obesity is a risk factor for the development of colon cancer. However, the influence of body mass index (BMI) on the outcome of patients with established colon cancer remains uncertain. Moreover, the impact of change in body habitus after diagnosis has not been studied. Patients and Methods We conducted a prospective, observational study of 1,053 patients who had stage III colon cancer and who were enrolled on a randomized trial of adjuvant chemotherapy. Patients reported on height and weight during and 6 months after adjuvant chemotherapy. Patients were observed for cancer recurrence or death. Results In this cohort of patients with stage III cancer, 35% of patients were overweight (BMI, 25 to 29.9 kg/m2), and 34% were obese (BMI ≥ 30 kg/m2). Increased BMI was not significantly associated with a higher risk of colon cancer recurrence or death (P trend = .54). Compared with normal-weight patients (BMI, 21 to 24.9 kg/m2), the multivariate hazard ratio for disease-free survival was 1.00 (95% CI, 0.72 to 1.40) for patients with class I obesity (BMI, 30 to 34.9 kg/m2) and 1.24 (95% CI, 0.84 to 1.83) for those with class II to III obesity (BMI ≥ 35 kg/m2) after analysis was adjusted for tumor-related prognostic factors, physical activity, tobacco history, performance status, age, and sex. Similarly, after analysis was controlled for BMI, weight change (either loss or gain) during the time period between ongoing adjuvant therapy and 6 months after completion of therapy did not significantly impact on cancer recurrence and/or mortality. Conclusion Neither BMI nor weight change was significantly associated with an increased risk of cancer recurrence and death in patients with colon cancer.

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