scholarly journals Research on Associations of MiR-149 with Nutritional Risk Assessment and Postoperative Complications of Patients with Colorectal Cancer

2021 ◽  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Roc Curves ◽  
Perioperative Period ◽  
Clinicopathological Characteristics ◽  
Nutritional Risk ◽  
State Variables ◽  
Nutritional Screening ◽  
Kappa Test ◽  
Significant Difference

Background: MiRNAs play an important role in the development of colorectal cancer, however, there’s few evidence of miRNAs in the screening of nutritional risks of patients with colorectal cancer. Objectives: To explore the role of preoperative miR-149 in nutritional screening of patients with CRC, and its associations with clinicopathological characteristics and postoperative complications of patients with CRC. Methods: The associations of serum miR-149 with clinicopathological characteristics and postoperative complications of patients were analyzed. The ROC curves were plotted with miR-149 as the test variable, and the grouping results of patients with nutritional risks [total NRS2002 score ≥3 points] and no nutritional risks (total NRS2002 score <3 points) based on the preoperative NRS2002 score as the state variables. The consistency of miR-149 and NRS2002 in nutritional screening of CRC was analyzed using Kappa test. Results: MiR-149 was low in patients with CRC. There was a statistically significant difference in the miR-149 expression among patients with different tumor diameters and TNM stages in the two groups. The preoperative total NRS2002 score of CRC patients was <3 points (without nutritional risks) in 271 cases, and ≥3 points (with nutritional risks) in 129 cases. The sensitivity and specificity of miR-149 in the diagnosis of nutritional risks were 76.74% and 84.50%. The Kappa value was 0.622 with miR-149 =3.095 as the critical value. Conclusions: MiR-149 can reflect the perioperative nutritional status of patients with CRC, and miR-149 =3.095 can be used as the cut-off point for nutritional risk screening of patients with CRC, which is an important index for assessing the nutritional risk in the perioperative period. The expression of miR-149 has a certain association with postoperative complications.

scholarly journals Change in Clinicopathological Characteristics of Patients With Colorectal Cancer During the COVID-19 Epidemic in China: a Single-institution Retrospective Analysis Based on Real-world Data

2021 ◽  
Author(s):  
Yu Yang ◽  
Yuxuan Li ◽  
Songyan Li ◽  
Xiaohui Du
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Tumor Staging ◽  
Neoadjuvant Chemoradiotherapy ◽  
Clinicopathological Characteristics ◽  
Real World Data ◽  
Global Epidemic ◽  
Significant Difference ◽  
Surgical Data ◽  
Colorectal Cancer Patients

Abstract Background: The coronavirus disease 2019 is in the global epidemic, which seriously affects the normal medical order. How to effectively manage colorectal cancer under the background of regular epidemic prevention and control need to gather the experience and wisdom of countries all over the world to study together.Methods: A retrospective observational study was performed to compare colorectal cancer patients’ clinical characters between the severe epidemic group (SEG,January 20, 2020 to March 20, 2020) versus the epidemic remission group (ERG, April 20, 2019 to June 20, 2020). The demographic characteristics, surgical data, postoperative pathological features and postoperative clinical characteristics of the two groups were compared.Results: 112 patients were enrolled in the study, including 47 patients in SEG and 65 patients in ERG. There was no significant difference in age, sex, height, weight and body mass index between two groups. The proportion of local patients in SEG was significantly higher than that in ERG (P=0.001). More patients in ERG received preoperative neoadjuvant chemoradiotherapy (Neo-CRT) (P=0.025). There was no significant difference in pT staging, pN staging and pM staging between the two groups (P > 0.05), but the overall pTNM staging was earlier in the SEG (P < 0.001). At the same time, the proportion of vascular invasion (P=0.004) and perineural invasion (P < 0.001) in SEG was higher than that in ERG. There were no postoperative complications in STG group, but 6 patients in ECG group had postoperative complications, including 4 cases of incision infection and 2 cases of anastomotic leakage. It should be noted that, 5 of these 6 patients received Neo-CRT before operation. Conclusion: our study shows that due to the interference of serious epidemic situation to medical activities and more patients choosing preoperative neoadjuvant chemoradiotherapy, some patients delayed operation to the period of the epidemic remission, which may lead to the progress of tumor staging and increase the risk of postoperative complications. In addition, we hope that our strategy for colorectal cancer diagnosis and treatment during the epidemic will help other surgeons.

scholarly journals The Clinical Utility of the Geriatric Nutritional Risk Index in Predicting Postoperative Complications and Long-Term Survival in Elderly Patients with Colorectal Cancer after Curative Surgery

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5852
Author(s):  
Chun-Kai Liao ◽  
Yih-Jong Chern ◽  
Yu-Jen Hsu ◽  
Yueh-Chen Lin ◽  
Yen-Lin Yu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Independent Risk Factor ◽  
Risk Index ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Curative Surgery ◽  
Term Survival ◽  
Nutritional Risk Index

Research on the relationship between the geriatric nutritional risk index (GNRI) and postoperative complications/oncological outcomes in elderly colorectal cancer (CRC) patients is limited. This study investigated the prognostic value of the GNRI in aged CRC patients. We retrospectively analyzed 1206 consecutive CRC patients aged over 75 years who underwent curative-intent surgery from January 2008 to December 2015 and categorized them into high GNRI (≥98) and low GNRI (<98) groups according to a receiver operating characteristic (ROC) curve analysis. Uni- and multivariate logistic regression analysis were used to explore the association of the GNRI with postoperative complications. Kaplan–Meier survival analyses and the Cox proportional hazard model were used to explore the association between GNRI and survival. We discovered that GNRI is an independent risk factor for postoperative complications (HR: 1.774, p = 0.037). Surgical site infection, wound dehiscence and pneumonia were more common in patients with GNRI < 98. Survival analysis showed significantly worse overall survival and disease-free survival in the low GNRI group (both p < 0.001). In the multivariate analysis, GNRI < 98 was an independent risk factor for OS (HR: 1.329, p = 0.031) and DFS (HR: 1.312, p = 0.034). Thus, preoperative GNRI can be effectively used to predict postoperative complications and long-term survival in elderly CRC patients after curative surgery.

The correlation between mismatch repair status and clinicopathological characteristics in Chinese colorectal cancer patients.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 544-544 ◽  
Author(s):  
Zhi-tao Xiao ◽  
Rong-xin Zhang ◽  
Yang Zhao ◽  
Jian-Hong Peng ◽  
Pei-Rong Ding ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Mismatch Repair ◽  
Mucinous Adenocarcinoma ◽  
Clinicopathological Characteristics ◽  
Left Colon ◽  
Stage Ii ◽  
Chinese Patients ◽  
Right Colon ◽  
Significant Difference

544 Background: Our study aimed to explore the relationship between mismatch repair (MMR) status and clinicopathological characteristics in Chinese patients with colorectal cancer (CRC). Methods: A total of 2684 patients with histologically confirmed adenocarcinoma of CRC were consecutively recruited between May 2011 and May 2015 at Sun Yat-sen University cancer center. The exclusion criteria included multiple primary tumors, synchronous and metachronous CRC, and familial adenomatous polyposis. The CRC was defined as left colon with the tumor located below the splenic flexure or rectum, otherwise grouped as right colon. Correlations of MMR status and patient’s demographics, tumor characteristics and TNM staging (exclude 315 CRC patients receiving neoadjuvant therapy) were investigated. Results: We found that deficient MMR (dMMR) status was more likely detected in younger CRC patients compared to the the elderly (12.7% vs 7.5%, P < 0.001). The dMMR rate in right colon cancer was significantly higher than that in left colon cancer and rectal cancer (22.7% vs 7.2% vs 5.2%, P < 0.001).With respect to tumor differentiation, we found that the mucinous adenocarcinoma had the highest rate of dMMR(24.4%), followed by poorly differentiated adenocarcinoma(18.5%), signet-ring cell carcinoma(17.6%), well differentiated adenocarcinoma(9.5%), moderately differentiated adenocarcinoma(8.9%), and neuroendocrine carcinoma (0%) ( P < 0.001). In addition, the proportions in stage I, stage II, stage III and stage IV CRC were 9.7%, 16.5% , 8.5% and 3.9%, respectively ( P < 0.001). There was no significant difference in gender (P = 0.114). Conclusions: At the first time, our study demonstrated that dMMR status was most likely detected at younger age (less than 59 years) and stage II right colon mucinous adenocarcinoma in large volume Chinese patients, which was similar to the results in western countries.

scholarly journals Computed Tomography–Determined Sarcopenia Is a Useful Imaging Biomarker for Predicting Postoperative Outcomes in Elderly Colorectal Cancer Patients

2020 ◽  
Vol 52 (3) ◽  
pp. 957-972 ◽  
Author(s):  
Hailun Xie ◽  
Yizhen Gong ◽  
Jiaan Kuang ◽  
Ling Yan ◽  
Guotian Ruan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Nutritional Risk ◽  
Imaging Biomarker ◽  
Imaging Data ◽  
Preoperative Nutrition

PurposeThis study aimed to establish whether computed tomography (CT)–determined sarcopenia is a useful imaging biomarker for postoperative outcome in elderly colorectal cancer (CRC) patients, and construct sarcopenia-based nomograms to predict individual outcomes after surgery.Materials and MethodsCT imaging data of 298 elderly CRC patients who underwent surgery in 2012-2014 were retrospectively analyzed. Skeletal muscle mass was determined by CT, and sarcopenia was diagnosed based on the optimal cutoff value determined by X-tile program. The correlation between sarcopenia and risk of preoperative nutrition and postoperative complications was evaluated. A Cox proportional hazards model was used to determine survival predictors. Sarcopenia-based nomograms were developed based on multivariate analysis, and calibrated using concordance index and calibration curves.ResultsA total 132 patients (44.3%) had sarcopenia based on the optimum cutoff values (29.9 cm2/m2 for women and 49.5 cm2/m2 for men). Sarcopenia was an independent risk factor for preoperative nutrition (p < 0.001; odds ratio [OR], 3.405; 95% confidence interval [CI], 1.948 to 5.954) and postoperative complications (p=0.008; OR, 2.192; 95% CI, 1.231 to 3.903). Sarcopenia was an independent predictor for poor progression-free survival (p < 0.001; hazard ratio [HR], 2.175; 95% CI, 1.489 to 3.179) and overall survival (p < 0.001; HR, 2.524; 95% CI, 1.721 to 3.703). Based on multivariate analysis, we produced four nomograms that had better predictive performance.ConclusionCT-determined sarcopenia is a useful imaging biomarker for predicting preoperative nutritional risk, postoperative complications, and long-term outcomes in elderly CRC patients. The sarcopenia-based nomograms can provide a scientific basis for guiding therapeutic schedule and follow-up strategies.

scholarly journals Uso perioperatório de probióticos em pacientes submetidos a ressecção de câncer colorretal: uma revisão sistemática

2020 ◽  
Vol 35 (1) ◽  
pp. 97-102
Author(s):  
Tainá Teixeira Ortega
Keyword(s):  
Colorectal Cancer ◽  
Clinical Trials ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Lower Incidence ◽  
Search Strategy ◽  
Randomized Clinical Trials ◽  
Perioperative Period ◽  
Infectious Complications ◽  
Intestinal Function

Introduction: Surgery is one of the main treatments for colorectal cancer and the use of probiotics may aid in the reduction of postoperative complications. This study aimed to review the clinical impacts of the use of probiotics in patients submitted to resection of colorectal cancer in the perioperative period. Methods: A bibliographic survey of the last ten years was carried out in the databases LILACS, MEDLINE and Scopus, using as a search strategy: probióticos (probiotics) and neoplasias colorretais (colorectal neoplasms) and período perioperatório (perioperative period), were selected only randomized clinical trials that met the purpose of the review. Results: Of the three eligible studies, two showed benefit in controlling infectious complications, two others contributed to a better recovery of intestinal function and all revealed lower incidence of diarrhea when administered perioperative probiotic, showing benefits in the recovery of these cancer patients. However, the literature on this subject is still limited, requiring more work well delineated methodologically to validate even these findings.

scholarly journals Prognostic significance of the Controlling Nutritional Status (CONUT) score in predicting postoperative complications in patients with Crohn’s disease

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Xue Dong ◽  
Shasha Tang ◽  
Wei Liu ◽  
Weilin Qi ◽  
Linna Ye ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Prognostic Significance ◽  
Prognostic Nutritional Index ◽  
Roc Curves ◽  
Postoperative Outcomes ◽  
Significant Difference ◽  
Conut Score

Abstract Preoperative immune-nutritional status is correlated with postoperative outcomes. The Controlling Nutritional Status (CONUT) score is a useful tool for predicting the postoperative outcomes of cancer surgery. This study aimed to evaluate whether the CONUT score could predict postoperative complications in Crohn’s disease (CD) patients. In total, 202 CD patients were eligible. Univariate and multivariate analyses were performed to identify risk factors for postoperative complications. Receiver operating characteristic (ROC) curves were generated to examine the cutoff value for predictors of postoperative complications. Among all the patients, 66 developed postoperative complications. The cut-off value of the CONUT score was 3.5 for complications. Eighty-one patients had a low CONUT score (< 3.5), and 121 patients had a high CONUT score (> 3.5). There was a significant difference in postoperative complications between the groups with low and high CONUT score (17.3% vs. 43.0%, p < 0.001). Patients with high CONUT score had low body mass index (BMI), more mild postoperative complications (p = 0.001) and a longer postoperative stay (p = 0.002). Postoperative complications were correlated with BMI, preoperative albumin, the preoperative CONUT score, and preoperative infliximab use. Then, the preoperative CONUT score was an independent risk factor for complications (OR 3.507, 95% CI 1.522–8.079, p = 0.003). ROC analysis showed that the CONUT score was a better predictor of postoperative complications in CD patients than albumin and the prognostic nutritional index. Thus, a preoperative CONUT score cut-off value of more than 3.5 could help to identify patients with a high possibility of malnutrition and postoperative complications.

scholarly journals PERIOPERATIVE CHANGES OF MICROBIOCENOSIS IN SURGICAL TREATMENT OF PATIENTS WITH COLORECTAL CANCER (review of literature)

2019 ◽  
Vol 178 (5) ◽  
pp. 132-138
Author(s):  
A. A. Zakharenko ◽  
V. V. Semiglazov ◽  
O. A. Ten ◽  
Sh. R. Djamilov ◽  
M. A. Belyaev ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Perioperative Period ◽  
Disease Recurrence ◽  
Review Of Literature ◽  
Cancer Disease ◽  
Cancer Review ◽  
The People ◽  
Oncological Diseases

Perioperative changes in microbiocenosis in patients with oncological diseases is the widely researched theme in colorectal surgery. In particular, the role of the colon microbiome in the development of purulent-inflammatory postoperative complications and possible significance in cancer disease recurrence have been actively investigated. Data on the colon microbiome tends to be divided on several groups. Part of the considered articles was focused on the condition of the colon microbiome during the perioperative period and its effect on the postoperative complications, in particular on the anastomotic leakage and the development of colitis in the postoperative period in dysbiosis statement. On the other hand, microbiome was evaluated to be a treatment option by the several studies. The effect of antibiotic therapy on the development of Clostridium Difficile infection was investigated as well. The most relevant and up-to-date scientific researches on the microbiocenosis in patients with colorectal cancer were analyzed. The collected data can be used successfully for practical medical using in Russia.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.

scholarly journals Effect of Preoperative Nutritional Risk Screening on Postoperative Recovery in Patients with Laparoscopic-Assisted Radical Resection for Colorectal Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Xiaolong Wang ◽  
Jianlin Wu ◽  
Sen Lei ◽  
Feng Tian ◽  
Ce Cao ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Postoperative Complications ◽  
Risk Group ◽  
Radical Resection ◽  
Nutritional Risk ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
Short Term ◽  
Colorectal Cancer Patients

Background and Objectives. This study investigated the effect of preoperative nutrition on the recovery and prognosis of colorectal cancer patients after laparoscopic radical resection. Methods and Study Design. A retrospective analysis was conducted on 120 colorectal cancer patients between January 2015 and August 2017. Patients were divided into two groups: those without nutritional risk (NRS 2002<3) and those with nutritional risk (NRS 2002≥3). The impacts of preoperative nutritional status on postoperative complications and short-term outcomes were analyzed. Finally, univariate and multivariate logistic regression analyses were used to study risk factors associated with postoperative complications. Results. There were statistically significant differences in BMI, albumin, total cholesterol, and lymphocyte count between patients from the two groups (all P<0.05). There was no difference in the incidence rate of postoperative complications between the two groups, but there was a statistically significant difference in the total number of complications (P<0.05). There were no significant differences between the two groups regarding abdominal drainage volume, exhaust (flatus) time, hospitalization cost, morbidity, or 60 d readmission rate (all P>0.05). However, patients with nutritional risk had higher postoperative blood transfusion volumes, albumin infusions, weight difference before and after surgery, and postoperative hospital stays than the nonnutritional risk group (all P<0.05). Smoking, diabetes, and preoperative nutritional risk were the risk factors by the univariate and multivariate logistic regression analyses. Conclusions. The postoperative complication rate was increased, and the short-term efficacy was decreased in the preoperative nutritional risk group compared with those without nutritional risk.

Is the Perioperative Continuation of Antiplatelet Therapy Safe for Elective Hernia Surgery?

2019 ◽  
Vol 85 (3) ◽  
pp. 303-305
Author(s):  
David A. Hill ◽  
Mohamad Sleiman ◽  
Michael R. Castellano
Keyword(s):  
Postoperative Complications ◽  
Hernia Repair ◽  
Antiplatelet Therapy ◽  
Anticoagulation Therapy ◽  
Perioperative Period ◽  
Antiplatelet Agents ◽  
Bleeding Complications ◽  
Hernia Surgery ◽  
Antiplatelet Medication ◽  
Significant Difference

Antiplatelet medication use in the perioperative period for elective surgical procedures remains controversial. We hypothesized that for elective hernioplasty, the continuation of antiplatelet agents would not increase postoperative complications. A single surgeon prospectively tracked all elective hernia repairs performed. All patients were included except those on anticoagulation therapy. Patients already on antiplatelet therapy (APT) continued their regimen throughout the perioperative period, whereas those who were not remained off antiplatelet medications. All patients had postoperative visits between 7 and 10 days at which point they were evaluated with complications documented. One thousand four patients underwent open hernia repair. Two hundred sixty-seven patients were taking APT, whereas 737 were not. The mean age of the antiplatelet group was greater than those not on APT (66 vs 51 years old, P < 0.0001). Ecchymosis occurred more frequently in the APT group than in those not on APT (9.36% vs 2.71%, P = 0.0005). This was the only statistically significant difference in postoperative complications noted between these two groups. Patients taking clopidogrel alone or a combination of aspirin and clopidogrel had a significantly higher rate of ecchymosis compared with those on other antiplatelet regiments (10%, 21.6%, and 7.4%, respectively, P = 0.047). There were no postoperative hematomas, bleeding complications, urinary retention, or any patients who required cessation of antiplatelet medications. Continuation of APT in the perioperative period for elective hernia repair did not result in an increased frequency of postoperative complications except for ecchymosis development. We conclude that the continuation of antiplatelet medications throughout the perioperative period of elective hernioplasty is safe.

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