Obesity and peritoneal surface disease: Outcomes following cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC).

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 533-533
Author(s):  
Konstantinos I Votanopoulos ◽  
Katrina R Swett ◽  
Doug S Swords ◽  
Perry Shen ◽  
John Stewart ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Postoperative Morbidity ◽  
Morbidity And Mortality ◽  
Low Grade ◽  
Obese Patients ◽  
Term Survival ◽  
Peritoneal Surface ◽  
Resection Status ◽  
Primary Colon ◽  
Survival Differences

533 Background: It is estimated that 35% of the US population is obese. It is unknown how obesity influences the operative and survival outcomes of CRS/HIPEC procedures. Methods: A retrospective analysis of a prospective database of 1,000 procedures was performed. Type of malignancy, ECOG, resection status, hospital and ICU stay, Clavien-Dindo morbidity, mortality and survival were reviewed. Results: 242 patients with BMI>30 (30-63.3) underwent 264 CRS/HIPEC procedures between 1991-2012. 94(38.8%) of those had a BMI>35. 136(51.7%) obese patients had appendiceal and 59(22.4%) colon cancer. Median follow up for obese patients was 52 months. Major (III /IV) and minor morbidity (I/II) was 36.6% and 28.8% for obese and 36.5% and 25.7% for non-obese patients. The 30 day mortality for obese and non-obese was 5.5% and 7.3% respectively. Median ICU and hospital stay was 1 and 9 days for both obese and non-obese. The 30 day readmission rate was similar between obese and non-obese patients 35.2% vs 30.8%. When patients were grouped by primary (colon or appendix), resection status, and grade of disease (for appendiceal) and stratified by BMI (not obese, 30-<35, ≥35) there was no difference in 30 day postoperative morbidity and mortality. When the interaction of obesity with the biology of the underlying primary was studied there was no obesity related survival differences. For obese and non-obese patients, median survival for low grade appendiceal cancer was 76 months and 107 months respectively (p=0.38) and for colon cancer was 18.1 months and 19.8 months. 5 and 10 year survival for the low grade appendiceal group was 60.5% and 33.1% for obese and 69.1% and 46.5% for non obese (p=0.38). Conclusions: Obesity does not influence postoperative morbidity and mortality of patients with peritoneal surface disease (PSD) regardless of primary. Obesity does not influence long term survival for appendiceal and colon cancer patients with PSD, and should not be considered a contraindication for the procedure.

Postoperative Morbidity in Curative Resection of Gastroesophageal Carcinoma Does Not Impact Long-term Survival

2015 ◽  
Vol 81 (12) ◽  
pp. 1228-1231
Author(s):  
Jennifer E. Samples ◽  
Anna C. Snavely ◽  
Michael O. Meyers
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Neoadjuvant Therapy ◽  
Postoperative Morbidity ◽  
Gastroesophageal Junction ◽  
Morbidity And Mortality ◽  
Term Survival ◽  
Long Term Survival ◽  
Nodal Dissection

Significant morbidity and mortality have historically been reported for surgical resection of gastric and gastroesophageal junction tumors. We evaluated our experience to determine morbidity and mortality and evaluated demographic and pathologic risk factors associated with postoperative outcome and long-term survival. A retrospective, Institutional Review Board-approved, single-institution database identified 102 patients who underwent resection with curative intent for gastroesophageal junction or gastric carcinoma from 2004 to 2012. The method of Kaplan and Meier was used to describe overall survival and estimate median survival. Of 102 patients, 74 were male and 28 were female. Of these, 24 patients were > 70 years of age at surgery (median = 62.9). Forty esophagectomies, 25 total gastrectomies, and 37 subtotal gastrectomies were performed. Two patients died (one esophagectomy and one gastrectomy). Forty-one developed a complication: 17 minor and 35 major, including six anastomotic leaks. Patients with low preoperative albumin ( P = 0.01) and increased age ( P = 0.05) were associated with having a postoperative complication; extent of nodal dissection ( P = 0.48), jejunostomy (0.24), performance status ( P = 0.77), type of surgery ( P = 0.74), and neoadjuvant therapy ( P = 0.24) were not associated. More extensive nodal dissection was associated with a decreased risk of death ( P = 0.007). Having any complication ( P = 0.20), an anastomotic leak ( P = 0.17), worse grade of complication ( P = 0.15), presence of feeding jejunostomy tube ( P = 0.17), and neoadjuvant therapy ( P = 0.30) were not associated with changes in overall survival. Thorough lymph node dissection improves survival without increasing postoperative morbidity. The data advocate for increased lymph node yield and close attention to nutritional support in gastroesophageal carcinoma patients.

30-Day Postoperative Morbidity of Emergency Surgery for Obstructive Right- and Left-Sided Colon Cancer in Obese Patients: A Multicenter Cohort Study of the French Surgical Association

2019 ◽  
Vol 37 (2) ◽  
pp. 111-118
Author(s):  
Laurent Genser ◽  
Gilles Manceau ◽  
Diane Mege ◽  
Valérie Bridoux ◽  
Zaher Lakkis ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Emergency Surgery ◽  
Postoperative Morbidity ◽  
Postoperative Mortality ◽  
Hemodynamic Instability ◽  
Normal Weight ◽  
Obese Patients ◽  
Multicenter Cohort Study ◽  
Mortality And Morbidity ◽  
Cardiovascular Comorbidity

Background: Emergency surgery impairs postoperative outcomes in colorectal cancer patients. No study has assessed the relationship between obesity and postoperative results in this setting. Objective: To compare the results of emergency surgery for obstructive colon cancer (OCC) in an obese patient population with those in overweight and normal weight patient groups. Methods: From 2000 to 2015, patients undergoing emergency surgery for OCC in French surgical centers members of the French National Surgical Association were included. Three groups were defined: normal weight (body mass index [BMI] < 25.0 kg/m2), overweight (BMI 25.0–29.9 kg/m2), and obese (BMI ≥30.0 kg/m2). Results: Of 1,241 patients, 329 (26.5%) were overweight and 143 (11.5%) were obese. Obese patients had significantly higher American society of anesthesiologists score, more cardiovascular comorbidity and more hemodynamic instability at presentation. Overall postoperative mortality and morbidity were 8 and 51%, respectively, with no difference between the 3 groups. For obese patients with left-sided OCC, stoma-related complications were significantly increased (8 vs. 5 vs. 15%, p = 0.02). Conclusion: Compared with lower BMI patients, obese patients with OCC had a more severe presentation at admission but similar surgical management. Obesity did not increase 30-day postoperative morbidity except stoma-related complications for those with left-sided OCC.

Complications and Challenges of Bariatric Surgery in Super-Obese Patients

2018 ◽  
Author(s):  
Shai Meron Eldar ◽  
Ofer Eldar
Keyword(s):  
Bariatric Surgery ◽  
Obese Patient ◽  
Patient Population ◽  
Postoperative Morbidity ◽  
Morbidity And Mortality ◽  
Operative Risk ◽  
Obese Patients ◽  
Super Obese ◽  
Lower Weight ◽  
Operative Complications

While the lower weight limits for bariatric surgery are already strictly set, the upper weight limits are still undetermined. The extremely obese patient deserves special consideration: significant comorbidities, technical difficulties, and increased postoperative morbidity and mortality are all expected in this patient population.In view of these factors, how should super-obese patients (BMI > 50 kg/m2) be approached, and is there any preferred procedure? Is there a point where operative risk outweighs surgical benefits? Bariatric surgery for super-obese and super-super-obese patients, including the operative complications and the associated morbidity and mortality, as well as the way they influence the approach to this subgroup of patients, are the subjects of this chapter.

CD133/CD166/Ki-67 Triple Immunouorescence Assessment for Putative Cancer Stem Cells in Colon Carcinoma*

2014 ◽  
Vol 23 (2) ◽  
pp. 161-170 ◽  
Author(s):  
Claudiu Margaritescu ◽  
Daniel Pirici ◽  
Irina Cherciu ◽  
Alexandru Barbalan ◽  
Tatiana Cârtâna ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Stem Cells ◽  
Colon Cancer ◽  
Cancer Stem Cells ◽  
Colon Carcinoma ◽  
Sodium Dodecyl ◽  
High Grade Dysplasia ◽  
Early Event ◽  
Low Grade ◽  
High Grade

Background & Aims: Colorectal cancer represents the third most common malignancy and the fourth most common cause of cancer death worldwide. The existence of drug-resistant colon cancer stem cells is thought to be one of the most important reasons behind treatment failure in colon cancer, their existence putatively leading to metastasis and recurrences. The aim of our study was to investigate the immunoexpression patterns of CD133 and CD166 in colon carcinoma, both individually and in combination, assessing their significance as prognostic markers.Methods. A total of 45 retrospective colon adenocarcinoma cases were investigated by enzymatic and multiple fluorescence immunohistochemistry for their CD133 and CD166 expression and colocalization.Results. Both CD133 and CD166 were expressed to different extents in all cancer specimens, with apredominant cytoplasmic pattern for CD133 and a more obvious membranous-like pattern for CD166.Overall, when comparing their reactivity for the tumoral tissue, CD166 expression areas seemed to be smaller than those of CD133. However, there was a direct correlation between CD133 and CD166 expression levels throughout the entire spectrum of lesions, with higher values for dysplastic lesions. Colocalization of CD133/ CD166 was obvious at the level of cells membranes, with higher coeficients in high grade dysplasia, followed by well and moderate differentiated tumours.Conclusions. CD133/CD166 colocalization is an early event occurring in colon tumorigenesis, with thehighest coeficients recorded for patients with high grade dysplasia, followed by well differentiated tumours. Thus, we consider that the coexpression of these two markers could be useful for further prognostic andtherapeutically stratification of patients with colon cancer.Abbreviations: AJCC - American Joint Committee on Cancer; CCD - charge-coupled device camera sensor; CD133 - prominin-1 (PROM1); CD166 - Activated Leukocyte Cell Adhesion Molecule (ALCAM); CRC - colorectal cancer; CSC - cancer stem cells; DAB - 3,3'-diaminobenzidine chromogen; DAPI - 4',6-diamidino- 2-phenylindole; HE - Hematoxylin and eosin staining; HGD - high grade dysplasia; HRP - horseradish peroxidase; LGD - low grade dysplasia; SDS - sodium dodecyl sulfate*Part of this work has been accepted as a poster presentation at the Digestive Disease Week (DDW) meeting, Chicago, IL, USA May 3-6, 2014

Eradication of minimal residual disease in the perioperative period in primary colon cancer

2015 ◽  
Vol 4 (4) ◽  
pp. 157-166 ◽  
Author(s):  
Paul H Sugarbaker ◽  
Paolo Sammartino ◽  
Antonios-Apostolos Tentes
Keyword(s):  
Colon Cancer ◽  
Minimal Residual Disease ◽  
Residual Disease ◽  
Perioperative Period ◽  
Primary Colon Cancer ◽  
Primary Colon ◽  
Minimal Residual

scholarly journals Treatment of tumor thrombus in the superior mesenteric vein due to advanced colon cancer with complete surgical resection and chemotherapy: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yoshitsugu Yanagida ◽  
Takahiro Amano ◽  
Ryuji Akai ◽  
Akira Toyoshima ◽  
Jotaro Kobayashi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Liver Metastasis ◽  
Surgical Resection ◽  
Tumor Thrombus ◽  
Superior Mesenteric Vein ◽  
Tumor Resection ◽  
Term Survival ◽  
Mesenteric Vein ◽  
Advanced Colon Cancer ◽  
Complete Surgical Resection

Abstract Background Tumor thrombus in the superior mesenteric vein secondary to colon cancer is rare. We report a case of tumor thrombus in the superior mesenteric vein and liver metastasis due to advanced colon cancer that was treated with chemotherapy and complete surgical resection. Case presentation A 72-year-old man after transverse colectomy with lymph node dissection for advanced colon cancer was diagnosed with tumor thrombus in the superior mesenteric vein and liver metastasis. He underwent adjuvant chemotherapy and had complete surgical tumor resection involving tumor thrombectomy and hepatectomy. There has been no recurrence at 36 months after surgery. Conclusion Herein, we report a rare case of tumor thrombus in the superior mesenteric vein related to advanced colon cancer. The combination of chemotherapy and complete surgical tumor resection may provide long-term survival.

scholarly journals Colorectal Metastasis from Ovarian Neoplasm Mimicking Primary Colon Cancer

2021 ◽  
pp. 41-46
Author(s):  
Anum Aqsa ◽  
Sami Droubi ◽  
Shivantha Amarnath ◽  
Fady Haddad ◽  
Liliane Deeb
Keyword(s):  
Colon Cancer ◽  
Previous History ◽  
Ovarian Neoplasm ◽  
Direct Visualization ◽  
Female Status ◽  
Internal Malignancy ◽  
Primary Colon Cancer ◽  
Primary Colon ◽  
History Of ◽  
Secondary Metastasis

Metastasis to the colon from another primary internal malignancy is an untypical and a seldom reported entity. Direct visualization during colonoscopy is considered the gold standard of diagnosis. Pathologic diagnosis with immunohistochemical staining is essential to differentiate primary colorectal malignancy from secondary metastasis to the colon. We, hereby, present a case of a 53-year-old female status-post resection of left-sided papillary serous ovarian neoplasm who presented 2 years later with a single rectosigmoid intraluminal ulcerative mass imitating a primary colon cancer. Biopsies of the mass were consistent with metastasis from her primary ovarian carcinoma. We believe this case is unique because of the rarity of ovarian cancer metastasizing to the colon intraluminally rather than through direct locoregional invasion. Furthermore, it highlights the importance of considering secondary metastasis in patients with previous history of another primary internal malignancy.

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