scholarly journals Results of surgical treatment of patients with stage IV colon cancer of older age groups and ways to improve them

2020 ◽  
Vol 22 (2) ◽  
pp. 45-50
Author(s):  
A. A. Sazonov
Keyword(s):  
Colon Cancer ◽  
Comparative Analysis ◽  
Surgical Treatment ◽  
Cancer Cells ◽  
Age Groups ◽  
Stage Iv ◽  
Long Term Results ◽  
Metastatic Colon Cancer ◽  
Ki 67

The effectiveness of cytoreductive operations in geriatric patients with stage IV colon cancer was assessed. A comparative analysis of the results of surgical treatment of metastatic colon cancer in patients of various age groups was carried out. The molecular biological properties of colon adenocarcinoma in patients with metastatic colorectal cancer were studied. The clinical significance of immunohistochemical markers as the proliferative index of stem cancer cells (ALDH+Ki-67+) and the chemokine receptor CXCR4 was determined for predicting the long-term results of surgical treatment of patients with stage IV colon cancer has been determined. It was found that the survival rates of elderly and senile patients are not inferior to those in patients under 60 years of age. A comparative analysis of the immediate and long-term results of treatment indicates the effectiveness of cytoreductive interventions in elderly and senile patients suffering from stage IV colon cancer. It was found that the expression level of the receptor for CXCR4 chemokines and the proliferative activity of stem cancer cells correlate with the life expectancy of patients after cytoreductive interventions and can be used to clarify the indications for their implementation.

Long-term results of surgical treatment of gastric cancer

1986 ◽  
Vol 67 (2) ◽  
pp. 104-106
Author(s):  
A. S. Abdullin ◽  
F. Sh. Akhmetzyanov ◽  
A. A. Samigullin ◽  
Z. N. Shemeunova ◽  
V. A. Arinin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Stomach Cancer ◽  
Stage Iv ◽  
Stage Ii ◽  
Stage Iii ◽  
Disease Stage ◽  
Long Term Results ◽  
Long Term Outcomes

We analyzed long-term outcomes of the treatment of 217 patients (men - 126, women - 91), who underwent radical operations for stomach cancer in the period of 1972 till 1976. 14 patients were under 39, 52 - from 40 to 49, 50 to 59 - 52, 60 to 69 - 80, over 70 years old - 19. The youngest patient was 28 years old and the oldest - 76 years old. Most patients (185) were operated on at stage III of the disease, stage II was diagnosed in 27 patients, and stage IV - in 5 patients.

scholarly journals Surgical treatment and rehabilitation capabilities of patients with patellar fractures

2019 ◽  
Vol 26 (1) ◽  
pp. 11-16 ◽  
Author(s):  
E. I Solod ◽  
N. V Zagorodniy ◽  
A. F Lazarev ◽  
M. B Tsykunov ◽  
M. A Abdulhabirov ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Conflict Of Interest ◽  
Long Term Results ◽  
Optimal Method ◽  
Results Of Treatment ◽  
Combination Osteosynthesis ◽  
Partial Patellectomy ◽  
Patellar Fractures

Relevance. Fractures of the patella represent about 1% of all fractures of the bones. Among surgeons there is no a single approach to the treatment of patients with many fragmentary patellar fractures. After surgical treatment of patients with patellar fractures, various complications could be observed. Aside from that, there is no consensus on the treatment of complex fractures of the patella, and in practice, trauma physicians use a variety of methods of osteosynthesis of the patella. In the light of the foregoing, the study of long-term results of patients after patellar fractures is of particular relevance. Purpose of study: to examine the results of patients after surgical treatment of patellar fractures with a view to devising best practices for its osteosynthesis. Patients and methods. A study of the results of treatment of 78 patients with patellar fractures was conducted. The following groups were identified depending on the type of surgery and the nature of the fracture: Weber osteosynthesis in fragmentary fractures; «cruciform osteosynthesis» and other identical options of osteosynthesis with spokes and wires at three or more fragmented fractures of the patella; combination osteosynthesis. A comparative analysis of the results of treatment of patients after partial patellectomy and osteosynthesis of the patella with spokes and tightening wire loops was conducted. We evaluated the results on the KOOS scale with clinical examination and x-ray examination of patients. Beyond that, we have supplemented this scale with the patients’ own opinion on the evaluation of the results of their treatment. Results. The average follow-up period was 22 months. A comparative analysis of the groups of patients after surgical treatment of patellar fractures on the KOOS scale showed the best results in osteosynthesis of transverse two-fragment patellar fractures by Weber’y - 72%. The results of treatment of patients with many fragmentary patellar fractures using 3-5 spokes and 2-3 wires was - 64%; after the rehabilitation of the lower pole was - 68%) and after partial patellectomy -51%. Conclusion. If a patient has three-fragmented patellar fractures, reasonable results could be achieved by using 3 spokes and 2 tightening wire loops. With four or more fragmentary fractures of the patella, the optimal method for its osteosynthesis is the use of a «cruciform» method with 4 or more spokes in combination with two or three wire loops. The use of patellectomy with subsequent fixation of the blocking wire loop should be avoided in all types of patellar fractures. Key words: patellar fracture, osteosynhesis, surgical treatment Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

Comparative analysis of second and subsequent chemotherapy lines on short- and long-term survival of elderly Medicare metastatic colon cancer patients.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 455-455
Author(s):  
Nader Hanna ◽  
Ebere Onukwugha ◽  
Kaloyan A Bikov ◽  
Zhiyuan Zheng ◽  
Brian S. Seal ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Comparative Analysis ◽  
Metastatic Colon Cancer ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Line Therapy ◽  
Short And Long Term ◽  
Diagnosis Date

455 Background: Metastatic colon cancer (mCC) patients often receive multiple lines of chemotherapy as treatment (TX) to improve survival or quality of life, yet the “real world” benefits and risks of multiple TX lines have not been fully examined. Methods: Elderly (65+) SEER-Medicare patients diagnosed with mCC in 2003-2007 were followed until death or 12/31/09 to examine the survival benefits for different chemotherapy lines. The median time between diagnosis date and the starting date of 2nd line was 352 days. Therefore, we restricted comparative analysis of 2nd and subsequent chemotherapy TX lines to patients who survived at least 1 year after mCC diagnosis date. We used Cox regression framework and adjusted for patients’ TX and censoring histories by using inverse probability weighting method. Separate analyses were conducted for short (2 years) and long-term (5 years) survival to examine different benefits of 2nd and subsequent chemotherapy lines. Results: Of 2,600 elderly Medicare mCC patients diagnosed between 2003-2007 and who survived at least 1 year, 2,530 were dead by the end of 2009. Significant factors associated with long-term survival were 1st line therapy(HR = 0.76; p < 0.01), 2nd line therapy (HR = 0.83; p < 0.01) , and subsequent chemotherapy line therapy(HR = 0.85; p = 0.04), as compared to no therapy, age groups 95+ (HR = 3.07; p < 0.01), 85-94 (HR = 1.33; p < 0.01), and 75-84 (HR = 1.10; p = 0.04) as compared to 65+-74, Asian vs. White (HR = 0.71; p < 0.01), and zip code level household median income (HR = 0.98; p = 0.01). For short-term survival, the benefits of 2nd and subsequent chemotherapy lines were maintained until month 29. Patients with poor performance status were less likely to proceed to 2nd line therapy. No statistically significant variables predicting receipt of subsequent chemotherapy lines were identified. Conclusions: Among elderly Medicare mCC patients who survived at least 1 year after diagnosis, 1st line therapy improved both short and long-term survival. 2nd and subsequent chemotherapy line therapy reduced short-term mortality (2 years); however, they didn’t add any additional long term survival benefit (5 years) as compared to 1st line therapy.

scholarly journals Molecular and biological aspects of forecasting the oncological efficiency of cytoreductive surgery in metastatic colon cancer

2021 ◽  
Vol 23 (3) ◽  
pp. 61-66
Author(s):  
Aleksey A. Sazonov ◽  
Nicolay A. Maistrenko ◽  
Pavel N. Romashchenko
Keyword(s):  
Stem Cells ◽  
Colon Cancer ◽  
Surgical Treatment ◽  
Cancer Stem Cells ◽  
Life Expectancy ◽  
Cytoreductive Surgery ◽  
Proliferative Activity ◽  
Stage Iv ◽  
Biological Properties ◽  
Metastatic Colon Cancer

Through an immunohistochemical study, the molecular biological properties of adenocarcinoma in patients with stage IV colorectal cancer with synchronous unresectable liver metastases, who underwent cytoreductive interventions for volume removal of the primary tumor, were examined. This study clarified the criteria for selecting patients with stage IV colon cancer with unresectable synchronous metastases in the liver for cytoreductive surgery from the standpoint of the molecular biological properties of the tumor. The prognostic significance of immunohistochemical markers such as the index of proliferative activity of stem cancer cells (ALDH + Ki-67 +) and the receptor for chemokines CXCR4 was established. The level of their expression correlates with the life expectancy of patients who underwent cytoreductive surgery. Thus, the high proliferative activity of cancer stem cells (ALDH + Ki67 + 50%) and the high expression of chemokine receptor (CXCR4 70%) correlate with the rapid disease progression after surgical treatment. A significant inverse relationship was traced between the expression level of the receptor for chemokine CXCR4 as well as the proliferative activity of cancer stem cells and life expectancy of patients with stage IV colon cancer after cytoreductive surgery. The expediency of immunohistochemical studies in patients with metastatic colon cancer has been substantiated. Its implementation provides important information about the potential for tumor aggressiveness, which makes it possible to clarify the indications for performing cytoreductive surgery and improve the results of surgical treatment of this category of patients.

scholarly journals Immediate and Long-Term Results of Treatment of Aneurysms of Ascending Aorta and Aortic Arch and Substantiation of Tactical Approaches to the Treatment Based on the Obtained Results

2021 ◽  
pp. 69-75
Author(s):  
Vitalii І. Kravchenko
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Hospital Mortality ◽  
Aortic Arch ◽  
Ascending Aorta ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Long Term Follow Up

Acute aortic dissection is a formidable disease. Its prevalence increases due to the population aging, as well as wider awareness of physicians about this pathology. The aim. To analyze immediate and long-term results of surgical treatment of aneurysms of ascending aorta and aortic arch and to determine optimal methods of correction of these lesions in order to improve the results of surgical treatment. Materials and methods. This was a comparative analysis of immediate and long-term treatment outcomes in 419 patients with aneurysms of ascending aorta and aortic arch. A comparative analysis of the results of treatment of two groups of patients was performed: the comparison group of 157 people operated before 2013, and the main group of 262 patients operated since 2013 using modified methods of aortic surgery. Results. The study showed significant reduction in the left ventricular dilatation according to echocardiography and satisfactory postoperative course in patients of both groups. Patients with valve-sparing aortic prosthetics had better results than those who underwent valve replacement surgery. Hospital mortality decreased from 17.2% to 5.3%. Analysis of long-term results showed that supracoronary aortic prosthetics with aortic valve plasty and elimination of the intimal tear zone make it possible to carry out effective aortic reconstruction. Due to events in the long run, regular lifelong monitoring is required. The analysis also showed that individualized approach to the choice of surgical tactics for the correction of aortic insufficiency in patients with aortic root and ascending aortic pathology allows to achieve comparable results in the immediate and long-term follow-up. Despite the complexity of the applied correction methods, the developed methods of surgical treatment of ascending aortic aneurysm (AAA) and aortic arch aneurysm and methods of protection of brain and visceral organs allowed to keep hospital mortality and the number of complications at the same level corresponding to one of the best world results. This gives hope for a good result in the long-term follow-up. Conclusions. Aneurysm of ascending aorta and aortic arch is a formidable life-threatening disease, and its only non-alternative treatment option is surgery. The optimized approach to the treatment of patients in the main group allowed to obtain better immediate and long-term results of surgical treatment and reduce postoperative complications from 34.4% to 8.4% and hospital mortality from 17.2% to 5.3%. Comparative analysis of long-term results in the studied groups showed more encouraging indicators of quality of life and life expectancy in patients when using modified surgical techniques, protection of the brain and visceral organs. We hope to get a final assessment of these data in the further study of the condition of these patients in the long-term follow-up.

scholarly journals Early and long-term results after Soave-Boley operation as the surgical treatment of colon agangliosis in children

2020 ◽  
pp. 37-42
Author(s):  
V.P. Prytula ◽  
◽  
D.Yu. Krivchenya ◽  
M.I. Silchenko ◽  
O.O. Kurtash ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Approach ◽  
Surgical Complications ◽  
Age Groups ◽  
Surgical Correction ◽  
Long Term Results ◽  
Anal Anastomosis ◽  
Manual Suture ◽  
Mechanical Stapler

Introduction. Сolon agangliosis (CA) belongs to a group of severe congenital malformations of the colon that can only be treated by surgical approach. The Soave-Boley technique is one of the most physiological and technically acceptable among pediatric surgeons from from all over the world. Aim – evaluate the early and long-term results of surgical treatment of CA in children by Soave-Boley method. Materials and methods. We analysed surgical treatment of 774 children with various forms of CA aged from birth to 18 years for the period from 1980 to 2020, using the Soave-Boley method by the formation of the primary colo-anal anastomosis by manual (suture) and mechanical (stapler) method. Results. All patients survived. Early postoperative surgical complications were seen in 19 (2.45%) of 774 children operated by Soave-Boley method: in 15 – after the formation of the primary colo-anal anastomosis by manual (sutures) method and 4 – after the imposition of a colo-anal anastomosis by mechanical (stapler) method. Long-term postoperative complications were noted in 15 (1.94%) of 774 children operated by Soave-Boley method: 14 – with a manual (suture) and 1 – with a mechanical (stapler) colo-anal anastomosis. Re-operation was successfully performed in 30 (3.87%) patients with reconstructing colo-anal anastomosis manually with Soave-Boley method after initial correction of CA in other clinics by other methods. Periodic episodes of soiling were seen in the remote period in 47 (6.07%) of 774 operated children which was treated conservatively. The success of the Soave-Boley technique is confirmed by a much lower number of early (2.45%) and long-term (1.94%) postoperative surgical complications, compared with those after the use of other methods of open surgical correction – 17.52% and 16.35%, respectively. Conclusions. Soave-Boley operation with colo-anal anastomosis by manual (suture) and mechanical (stapler) methods in comparison with other methods is the most effective method of radical correction of CA as open surgical approach in children of different age groups as single staged or double staged interventions. According to the technical capabilities and results of the early and long period, the Soave-Boley technique with colo-anal anastomosis by manual (ligature) method is the operation of choice for both primary and re-surgical correction of CA compared to any other methods. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. No conflict of interest was declared by the authors. Key words: agangliosis, colon, children, surgical treatment, results.

LONG TERM opioid use in RURAL NON-metastatic colon cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15174-e15174
Author(s):  
Emilio Paul Araujo-Mino ◽  
Ajaz Bulbul ◽  
Hamza Minhas ◽  
Adriana Bautista ◽  
Lisa Lentkowski ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Stage Iv ◽  
Stage I ◽  
Smoking History ◽  
Prescription Opioid ◽  
Metastatic Colon Cancer ◽  
Opioid Use ◽  
One Year ◽  
Opioid Users

e15174 Background: Cancer related pain and subsequent long-term opioid (LTO) use worsens the opioid epidemic and facilitates abuse. Non-metastatic colon cancer (CC) is a potentially curable malignancy and prescription opioid (PO) may increase risks of adverse events when CC has been eradicated. Methods: A retrospective study evaluated stage I-III CC patients between January 2013 and January 2018 across rural cancer clinics in New Mexico who received PO during their cancer diagnosis and treatment. It excluded patients with stage IV CC, concurrent malignancies and non-cancer pain. Descriptive statistics, Chi-square and logistic regression were performed to identify correlation and predictors of LTO use. Results: Among 197 patients identified, opioids were prescribed in 24% (48/197); 22 patients met inclusion criteria. Mean age was 65.1±9.8 years; 68% male; Stage I (4.5%), II (36.3%), III (59.1%). Adjuvant chemotherapy was given in 91% (20/22). Oxaliplatin regimen was used in 63.6% (14/22). One year after therapy, 27.3% (6/22) still had neuropathy. The rate of opioid use was 72.7% (16/22) at 3 months, 54.5% (12/22) at 6 months and 41% (9/22) at 12 months; 56.2% (9/16) of opioid users at 3 months were also using opioids at 12 months from initial prescription (X2 5.71 p = 0.046). Also, 75% (9/12) of opioid users at 6 months, continued using opioids at 12 months (X2 12.7 p = 0.0001). Patients with smoking history, unemployed and PO from a surgeon, were more likely to be LTO users at 12 months; however, it was not statistically significant. Conclusions: Non-metastatic CC patients who continue to use opioids at 3 months are at a significantly higher risk of LTO use at one year. Biological and social factors in rural communities can be important determinants of this use pattern. The challenges surrounding opioid use and the need for safe and effective alternative analgesics require urgent attention and regulatory discourse.

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