The impact of body mass index on short-term and long-term surgical outcomes of laparoscopic hepatectomy in liver carcinoma patients, a retrospective study

Abstract Background To investigate the influence of body mass index (BMI) on the short-term and long-term outcomes including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment. Methods Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI < 18.5 kg/ m2, Group1), normal (18.5 ≤ BMI < 23 kg/m2, Group2), overweight (BMI ≥ 23 kg/m2, Group3) respectively. Short-term and long-term outcomes including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories. Results Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44%. Conversion rate in the three groups was 14.29%, 21.54% and 20.69% (P = 0.8284). The median follow-up duration was 26 months, 30 months, and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85 ± 4.04, 11.57 ± 5.56, and 10.88 ± 5.70, P = 0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P = 0.048). Underweight patients were more likely to develop grade III or higher postoperative complications (Clavien-Dindo classification) as compared to normal and overweight patients (P = 0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P = 0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P = 0.043). Conclusions Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH.

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The impact of body mass index on short-term and long-term surgical outcomes of laparoscopic hepatectomy in liver carcinoma patients, a retrospective study

10.21203/rs.3.rs-24269/v1 ◽

2020 ◽

Author(s):

Lei Zhao ◽

Gang Jian Wang ◽

Jingxia Kong ◽

Xing Zhen ◽

Xin Yu

Keyword(s):

Body Mass Index ◽

Laparoscopic Hepatectomy ◽

Disease Free Survival ◽

Normal Weight ◽

Liver Carcinoma ◽

Long Term Outcomes ◽

Short Term ◽

Free Survival ◽

Disease Free

Abstract Background: To investigate the influence of body mass index (BMI) on the short-term and long-term outcomes including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment.Methods: Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI< 18.5kg/ m2, Group1), normal (18.5≤BMI< 23kg/m2, Group2), overweight (BMI≥ 23kg/m2, Group3) respectively. Short-term and long-term outcomes including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories.Results: Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44 %. Conversion rate in the three groups was 14.29%, 21.54% and 20.69 % (P=0.8284). The median follow-up duration was 26 months, 30 months, and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85±4.04, 11.57±5.56, and 10.88±5.70, P=0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P=0.048). Underweight patients were more likely to develop grade III or higher postoperative complications (Clavien-Dindo classification) as compared to normal and overweight patients (P=0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P=0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P=0.043).Conclusions: Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH.

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The impact of body mass index on short-term and long-term surgical outcomes of laparoscopic hepatectomy in liver carcinoma patients, a retrospective study

10.21203/rs.2.14004/v1 ◽

2019 ◽

Author(s):

Zhao Lei ◽

Wang Jian Gang ◽

Zheng Xing ◽

Yu Xin

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Laparoscopic Hepatectomy ◽

Disease Free Survival ◽

Normal Weight ◽

Liver Carcinoma ◽

Short Term ◽

Term Outcome ◽

Long Term Outcome

Abstract Background : To investigate the influence of body mass index (BMI) on the short-term and long-term outcome s including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment.Methods: Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI< 18.5kg/ m 2 , Group1), normal (18.5≤BMI< 23kg/m 2, Group2), overweight (BMI≥ 23kg/m 2, Group3) respectively. Short-term and long-term outcome s including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories.Results: Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44 %. Conversion rate in the three groups was 14.29%, 21.54% and 20.69 % (P=0.8284). The median follow-up duration was 26 months , 30 months , and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85±4.04, 11.57±5.56 , and 10.88±5.70, P=0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P=0.048). Underweight patients were more likely to develop grade III or higher postoperative complications ( Clavien-Dindo classification ) as compared to normal and overweight patients (P=0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P=0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P=0.043).Conclusions : Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH. Key Word s: body mass index, liver carcinoma, Prognosis, laparoscopic hepatectomy

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LongTerm Outcomes of Three-Port Laparoscopic Right Hemicolectomy Versus Five-Port Laparoscopic Right Hemicolectomy: A Retrospective Study

Frontiers in Oncology ◽

10.3389/fonc.2021.762716 ◽

2021 ◽

Vol 11 ◽

Author(s):

Tao Zhang ◽

Yaqi Zhang ◽

Xiaonan Shen ◽

Yi Shi ◽

Xiaopin Ji ◽

...

Keyword(s):

Disease Free Survival ◽

Right Hemicolectomy ◽

Long Term Outcomes ◽

Short Term ◽

Free Survival ◽

Oncological Outcomes ◽

Short And Long Term ◽

Laparoscopic Right Hemicolectomy ◽

Disease Free

PurposeThe aim of this study is to compare the long-term outcomes of three-port laparoscopic right hemicolectomy (TPLRC) and five-port laparoscopic right hemicolectomy (FPLRC) with retrospective analysis.MethodsA total of 182 patients who accepted laparoscopic right hemicolectomy with either three ports (86 patients) or five ports (96 patients) from January 2012 to June 2017 were non-randomly selected and analyzed retrospectively.ResultsMore lymph nodes were harvested in the TPLRC group than in the FPLRC group [17.5 (7), 14 (8) ml, p < 0.001]. There was less blood loss in the TPLRC group [50 (80) vs. 100 (125) ml, p = 0.015]. There were no significant differences in the other short-term or oncological outcomes between the two groups. The overall survival and disease-free survival were equivalent.ConclusionsTPLRC is recommendable as it guarantees short- and long-term equivalent outcomes compared with FPLRC.

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Long-Term Outcomes and Factors Related to the Prognosis of Pure Ovarian Dysgerminoma: A Retrospective Study of 107 Cases

Gynecologic and Obstetric Investigation ◽

10.1159/000519515 ◽

2021 ◽

pp. 1-8

Author(s):

Tianyun Xu ◽

Fei Sun ◽

Yanfang Li

Keyword(s):

Retrospective Study ◽

Survival Rate ◽

Disease Free Survival ◽

Small Sample ◽

Stage I ◽

Long Term Outcomes ◽

Free Survival ◽

Disease Free Survival Rate ◽

Disease Free

Objective: The aim of this study was to evaluate the long-term outcomes and the factors related to patient prognosis. Materials and Methods: We retrospectively analyzed patients treated at the Department of Gynecology, Sun Yat-sen University Cancer Center, between January 1, 1968, and December 12, 2018. Results: A total of 107 patients were identified. Of all patients, 79 (73.8%) presented with stage I disease, 14 (13.1%) stage II, 13 (12.2%) stage III, and 1 (0.9%) stage IV. All patients received surgery, with 70 (65.4%) undergoing fertility-sparing surgery (FS) and 37 (34.6%) nonfertility-sparing surgery (NFS). Ninety patients received postoperative chemotherapy. Nine of the 43 cases with a lymphadenectomy had metastasis (20.9%). The median follow-up time was 132 months (range, 1–536 months). The overall 5-year and 10-year survival was 95.1% and 91.7%, respectively. The 10-year survival rate for stage I and II–IV patients was 96.1% and 79.1%, respectively (p = 0.008). For the patients undergoing FS and NFS, the 10-year disease-free survival rate was 82.3% and 88.0%, respectively (p = 0.403). The 10-year disease-free survival rate for patients with or without lymphadenectomy was 95.1% and 78.4%, respectively (p = 0.040), and it was 92.5% and 76.0%, respectively (p = 0.041), for those with or without omentectomy. Fifteen patients relapsed, and 4 of them (26.7%) had recurrence in the lymph nodes. Eleven of the 15 relapsed patients (73.3%) had been successfully salvaged. Limitations: As a study of a rare disease, our analysis was limited by its small sample size and the deemed disadvantage of a retrospective study. Conclusion: Excellent treatment results can be achieved in dysgerminoma patients who received proper treatment. Lymphadenectomy may improve patient survival. Relapsed patients can also be successfully salvaged.

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Comparison of short- and long-term outcomes between 3-field and modern 2-field lymph node dissections for thoracic oesophageal squamous cell carcinoma: a propensity score matching analysis

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz108 ◽

2019 ◽

Vol 29 (3) ◽

pp. 434-441 ◽

Cited By ~ 1

Author(s):

Ningbo Fan ◽

Han Yang ◽

Jiabo Zheng ◽

Dongni Chen ◽

Weidong Wang ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Disease Free Survival ◽

Oesophageal Squamous Cell Carcinoma ◽

Long Term Outcomes ◽

Free Survival ◽

Short And Long Term ◽

Disease Free

Abstract OBJECTIVES Our goal was to compare short- and long-term outcomes between 3-field lymphadenectomy (3-FL) and modern 2-field lymphadenectomy (2-FL) in patients with thoracic oesophageal squamous cell carcinoma. METHODS We reviewed clinical outcomes for 298 patients with thoracic oesophageal squamous cell carcinoma who underwent 3-FL or modern 2-FL from March 2008 to December 2013 at a major cancer hospital in Guangzhou, southern China. Propensity score matching was used to balance baseline differences, and 83 pairs of cases were selected. Postoperative complications, recurrence patterns and survival outcomes were compared between the 2 groups. RESULTS Compared with modern 2-FL, 3-FL led to higher overall operative morbidity rates [78.3% vs 61.4%, odds ratio (OR) 2.266, 95% confidence interval (CI) 1.143–4.490; P = 0.019], with higher recurrent nerve palsy rates (47.0% vs 19.3%, OR 3.712, 95% CI 1.852–7.438; P < 0.0001), more respiratory failures (18.1% vs 6.0%, OR 3.441, 95% CI 1.189–9.963; P = 0.023) and longer postoperative hospital stays (23 vs 17 days, P = 0.002). The 5-year overall survival rate (58.5% vs 59.4%; P = 0.960) and the 5-year disease-free survival rate 50.1% vs 54.5%; P = 0.482) were comparable between the 2 groups. Multivariable analysis showed that additional cervical lymph node dissection was not associated with overall survival [hazard ratio (HR) 1.039, 95% CI 0.637–1.696; P = 0.878] and disease-free survival (HR 0.868, 95% CI 0.548–1.376; P = 0.547). The overall recurrence rate and cervical nodal recurrence rate were not significantly different between the 2 groups. CONCLUSIONS Additional cervical lymphadenectomy did not lead to added survival benefit when compared with modern 2-FL in patients with thoracic oesophageal squamous cell carcinoma. Recurrence was similar in patients undergoing 3-FL and modern 2-FL. 3-FL resulted in more postoperative complications.

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CRITICAL EVALUATION OF LONG-TERM RESULTS OF MALIGNANT HEPATIC TUMORS TREATED BY MEANS CURATIVE LAPAROSCOPIC HEPATECTOMY

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201700030010 ◽

2017 ◽

Vol 30 (3) ◽

pp. 205-210 ◽

Cited By ~ 2

Author(s):

Sergio Renato PAIS-COSTA ◽

Sergio Luiz Melo ARAÚJO ◽

Olímpia Alves Teixeira LIMA ◽

Sandro José MARTINS

Keyword(s):

Overall Survival ◽

Tumor Recurrence ◽

Malignant Tumors ◽

Laparoscopic Hepatectomy ◽

Disease Free Survival ◽

Long Term Results ◽

Colorectal Metastases ◽

Free Survival ◽

Disease Free

ABSTRACT Background: Laparoscopic hepatectomy has presented great importance for treating malignant hepatic lesions. Aim: To evaluate its impact in relation to overall survival or disease free of the patients operated due different hepatic malignant tumors. Methods: Thirty-four laparoscopic hepatectomies were performed in 31 patients with malignant neoplasm. Patients were distributed as: Group 1 - colorectal metastases (n=14); Group 2 - hepatocellular carcinoma (n=8); and Group 3 - non-colorectal metastases and intrahepatic cholangiocarcinoma (n=9). The conversion rate, morbidity, mortality and tumor recurrence were also evaluated. Results: Conversion to open surgery was 6%; morbidity 22%; postoperative mortality 3%. There was tumor recurrence in 11 cases. Medians of overall survival and disease free survival were respectively 60 and 46 m; however, there was no difference among studied groups (p>0,05). Conclusion: Long-term outcomes of laparoscopic hepatectomy for treating hepatic malignant tumors are satisfactory. There is no statistical difference in relation of both overall and disease free survival among different groups of hepatic neoplasms.

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Long-term outcomes of stenting as a bridge to surgery for acute left-sided malignant colonic obstruction.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e14032 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e14032-e14032

Author(s):

Fayez A. Quereshy ◽

Jensen T.C. Poon ◽

Wai Lun Law

Keyword(s):

Overall Survival ◽

Surgical Resection ◽

Survival Data ◽

Colonic Obstruction ◽

Disease Free Survival ◽

Bridge To Surgery ◽

Long Term Outcomes ◽

Short Term ◽

Disease Free

e14032 Background: Stenting as a bridge to surgery has been increasingly applied in cases of acute left-sided colonic obstruction. This study aims to evaluate both the short and long-term outcomes associated with colonic stenting as a bridge to surgery in patients with obstructing adenocarcinoma of the colon. Methods: Patients with potentially curable acute left-sided colonic obstruction treated with stenting as a bridge to surgery (28) or with emergency surgical resection (39) from January 1998 to December 2008 were identified using a prospectively maintained database. Short-term data on post-operative mortality, morbidity, necessity of intensive care, and length of hospital stay were compared. Disease-free and overall survival data were also analyzed. Results: Patients within the two study arms had similar demographic profiles. Patients receiving preoperative stenting had a higher likelihood of a laparoscopic resection (p<0.001). Further, the emergency surgery group had a higher rate of post-operative complications (p=0.024), rate of ICU admission (p=0.013), and longer total length of stay (9 vs. 12 days, p=0.001). With a median follow-up of 26.5 and 31.3 months for the stenting and surgical resection groups respectively, there was no difference in overall and disease-free survival (overall survival = 30 vs. 31 months, p=0.858; DFS = 13 vs. 12 months, p=0.989). As well, there was no difference in the rate of systemic recurrences (8 vs. 13, p=0.991). Conclusions: Stenting as a bridge to surgery is a safe treatment strategy in the management of patients with acute left-sided colonic obstruction with improved short-term outcomes and comparable long-term oncologic results.

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Five-Year, Disease-Free Survival after Repeat Palliative Multimodality Therapy in a Patient with Recurrent Metastastic Bladder Cancer

The Scientific World JOURNAL ◽

10.1100/tsw.2007.283 ◽

2007 ◽

Vol 7 ◽

pp. 1736-1742

Author(s):

Sebastian Fetscher ◽

Jan Schmielau ◽

Wolfgang Schulze-Seemann

Keyword(s):

Bladder Cancer ◽

Treatment Strategies ◽

Disease Free Survival ◽

Term Treatment ◽

Short Term ◽

Course Of Disease ◽

Free Survival ◽

Long Term Treatment ◽

Disease Free

In appropriately selected cases, palliative therapeutic strategies can be adapted to those special features of cancer biographies that indicate an atypical course of disease. Elucidating these features, and adapting multimodal treatment strategies to them, can lead to significantly superior effects when compared to the routine application of conventional treatment algorhythms. A case of regionally metastactic bladder cancer is presented that documents the value of repeat debulking-surgery and repeat radiotherapy leading to unexpected short-term and long-term treatment results.

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Impact of clinical response to neoadjuvant endocrine therapy on patient outcomes: a follow-up study of JFMC34-0601 multicentre prospective neoadjuvant endocrine trial

ESMO Open ◽

10.1136/esmoopen-2017-000314 ◽

2018 ◽

Vol 3 (2) ◽

pp. e000314 ◽

Cited By ~ 9

Author(s):

Takayuki Ueno ◽

Shigehira Saji ◽

Norikazu Masuda ◽

Katsumasa Kuroi ◽

Nobuaki Sato ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Response ◽

Endocrine Therapy ◽

Prognostic Value ◽

Disease Free Survival ◽

Long Term Outcomes ◽

Neoadjuvant Endocrine Therapy ◽

Free Survival ◽

Disease Free

BackgroundNeoadjuvant endocrine therapy (NET) has been demonstrated to improve breast-conserving rate and is a widely accepted treatment option for postmenopausal patients with hormone receptor-positive breast cancer. There are few reports on the association of NET response and long-term outcomes.ObjectivesTo investigate the prognostic value of clinical response to NET.MethodsLong-term outcomes of NET were examined in 107 patients who participated in the multicentre prospective neoadjuvant exemestane study, JFMC34-0601. Patients were treated with 25 mg/day exemestane for 16 weeks followed by an 8-week extension depending on the treatment response.ResultsClinical response included partial response (PR) in 58 patients, stable disease in 41 patients and progressive disease (PD) in 8 patients. Clinical response was significantly associated with disease-free survival (DFS), distant disease-free survival (DDFS) and overall survival (OS) (P<0.0001 for all). Especially, patients with PD showed markedly poor outcomes with median DFS=17.8 months (HR (vs PR): 7.7 (95% CI 1.6 to 33)) and median OS=37.7 months (HR (vs PR): 26.3 (95% CI 2.4 to 655)). Preoperative endocrine prognostic index (PEPI) were associated with DFS and marginally with OS (P=0.022 and 0.066, respectively). PEPI=0 indicated an excellent prognosis with 95% 5-year DFS (95% CI 73 to 99). In the multivariate analysis including T stage, nodal status and Ki67, clinical response was an independent prognostic factor for DFS, DDFS and OS (P=0.032, 0.0007 and 0.020, respectively), whereas PEPI was marginally associated with DFS and OS (P=0.079 and 0.068, respectively).ConclusionsClinical response to NET showed an independent prognostic value. Patients with PD had markedly poor prognosis, indicating a need of additional therapy. PEPI=0 indicated an excellent prognosis. The integration of clinical response and PEPI would improve decision-making with regard to treatment options for endocrine-responsive breast cancer when these results are validated in a larger clinical trial.Trial registration numberUMIN C000000345.

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Long-term and short-term outcomes of robot- versus video-assisted anatomic lung resection in lung cancer: a systematic review and meta-analysis

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa426 ◽

2020 ◽

Author(s):

Han Wu ◽

Runsen Jin ◽

Su Yang ◽

Bernard J Park ◽

Hecheng Li

Keyword(s):

Overall Survival ◽

Thoracic Surgery ◽

Open Surgery ◽

Lung Resection ◽

Disease Free Survival ◽

Short Term ◽

Free Survival ◽

Anatomic Lung Resection ◽

Disease Free

Abstract OBJECTIVES Minimally invasive thoracic surgery has evolved with the introduction of robotic platforms. This study aimed to compare the long-term and short-term outcomes of the robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) for anatomic lung resection. METHODS We searched published studies that investigated RATS and VATS in anatomic lung resection. Long-term outcomes (disease-free survival and overall survival) and short-term outcomes (30-day mortality, postoperative complications, conversion rate to open surgery and lymph node upstaging) were extracted. The features were compared and tested as hazard ratios (HRs) and odds ratios (ORs) at a 95% confidence interval (CI). RESULTS Twenty-five studies with 50 404 patients (7135 for RATS and 43 269 for VATS) were included. The RATS group had a longer disease-free survival than the VATS group (HR: 0.76; 95% CI: 0.59–0.97; P = 0.03), and the overall survival showed a similar trend but was not statistically significant (HR: 0.77; 95% CI: 0.57–1.05; P = 0.10). The RATS group showed a significantly lower 30-day mortality (OR: 0.55; 95% CI: 0.38–0.81; P = 0.002). No significant difference was found in postoperative complications (OR: 1.01; 95% CI: 0.87–1.16; P = 0.94), the conversion rate to open surgery (OR: 0.92; 95% CI: 0.56–1.52; P = 0.75) and lymph node upstaging (OR: 0.89; 95% CI: 0.52–1.54; P = 0.68). CONCLUSIONS RATS has comparable short-term outcomes and potential long-term survival benefits for anatomic lung resection compared with VATS.

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