scholarly journals Clinical Outcomes Following Re-Operations for Intracranial Meningioma

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4792
Author(s):  
George E. Richardson ◽  
Conor S. Gillespie ◽  
Mohammad A. Mustafa ◽  
Basel A. Taweel ◽  
Ali Bakhsh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Performance Status ◽  
Progression Free Survival ◽  
World Health ◽  
Intracranial Meningioma ◽  
Complication Rates ◽  
Patient Goals ◽  
Operative Complications ◽  
Post Operative Complications

The outcomes following re-operation for meningioma are poorly described. The aim of this study was to identify risk factors for a performance status outcome following a second operation for a recurrent meningioma. A retrospective, comparative cohort study was conducted. The primary outcome measure was World Health Organization performance. Secondary outcomes were complications, and overall and progression free survival (OS and PFS respectively). Baseline clinical characteristics, tumor details, and operation details were collected. Multivariable binary logistic regression was used to identify risk factors for performance status outcome following a second operation. Between 1988 and 2018, 712 patients had surgery for intracranial meningiomas, 56 (7.9%) of which underwent a second operation for recurrence. Fifteen patients (26.8%) had worsened performance status after the second operation compared to three (5.4%) after the primary procedure (p = 0.002). An increased number of post-operative complications following the second operation was associated with a poorer performance status following that procedure (odds ratio 2.2 [95% CI 1.1–4.6]). The second operation complication rates were higher than after the first surgery (46.4%, n = 26 versus 32.1%, n = 18, p = 0.069). The median OS was 312.0 months (95% CI 257.8–366.2). The median PFS following the first operation was 35.0 months (95% CI 28.9–41.1). Following the second operation, the median PFS was 68.0 months (95% CI 49.1–86.9). The patients undergoing a second operation for meningioma had higher rates of post-operative complications, which is associated with poorer clinical outcomes. The decisions surrounding second operations must be balanced against the surgical risks and should take patient goals into consideration.

EquineReview

UK-Vet Equine ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 114-114
Author(s):  
Kate McGovern
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Operative Complications ◽  
Post Operative Complications

Introduction: this edition of Equine Review considers papers on risk factors for post-operative complications following umbilical resection in foals, use of intrasplenic phenyleprine in nephrosplenic entrapment of the large colon, and clinical outcomes following chemotherapy for lymphomas in equids.

scholarly journals The impact of pre-operative biologic therapy on post-operative surgical outcomes in ulcerative colitis: a systematic review and meta-analysis

2020 ◽  
Vol 13 ◽  
pp. 175628482093708
Author(s):  
Jasmine Zanelli ◽  
Subashini Chandrapalan ◽  
Abhilasha Patel ◽  
Ramesh P. Arasaradnam
Keyword(s):  
Ulcerative Colitis ◽  
Biologic Therapy ◽  
Meta Analysis ◽  
Complication Rates ◽  
Surgical Morbidity ◽  
Biologic Treatment ◽  
Operative Care ◽  
Operative Complications ◽  
The Impact ◽  
Post Operative Complications

Background and aims: Biologic therapy has emerged as an effective modality amongst the medical treatment options available for ulcerative colitis (UC). However, its impact on post-operative care in patients with UC is still debatable. This review evaluates the risk of post-operative complications following biologic treatment in patients with UC. Methods: A systematic search of the relevant databases was conducted with the aim of identifying studies that compared the post-operative complication rates of UC patients who were either exposed or not exposed to a biologic therapy prior to their surgery. Outcomes of interest included both infection-related complications and overall surgical morbidity. Pooled odds-ratio (OR) and 95% confidence intervals (CI) were calculated using Review Manager 5.3. Results: In all, 20 studies, reviewing a total of 12,494 patients with UC, were included in the meta-analysis. Of these, 2254 patients were exposed to a biologic therapy prior to surgery. The pooled ORs for infection-related complications ( n = 8067) and overall complications ( n = 11,869) were 0.98 (95% CI 0.66–1.45) and 1.14 (95% CI 1.04–1.28), respectively, which suggested that there was no significant association between the use of pre-operative biologic therapy and post-operative complications. Interestingly, the interval between the last dose of biologic therapy and surgery did not influence the risk of having a post-operative infection. Conclusions: This meta-analysis suggests that pre-operative biologic therapy does not increase the overall risk of having post-operative infection-related or other complications. PROSPERO registration id-CRD42019141827.

scholarly journals Risk Factors for Post-operative Complications in Primary Oral Cancer Surgery—a Prospective Study

2017 ◽  
Vol 9 (1) ◽  
pp. 28-34 ◽  
Author(s):  
G. M. Divya ◽  
Nujum Zinia ◽  
P. G. Balagopal ◽  
Varghese T. Bipin ◽  
Iype Mathew Elizabeth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Oral Cancer ◽  
Prospective Study ◽  
Cancer Surgery ◽  
Operative Complications ◽  
A Prospective Study ◽  
Post Operative Complications

Regorafenib (REG) versus trifluridine/tipiracil (TAS-102) as salvage-line in patients with metastatic colorectal cancer refractory to standard chemotherapies (REGOTAS): A propensity score analysis from a JSCCR multicenter observational study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 3540-3540 ◽  
Author(s):  
Shota Fukuoka ◽  
Toshikazu Moriwaki ◽  
Hiroya Taniguchi ◽  
Atsuo Takashima ◽  
Yosuke Kumekawa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Propensity Score ◽  
Metastatic Colorectal Cancer ◽  
Clinical Outcomes ◽  
Propensity Score Analysis ◽  
Performance Status ◽  
Progression Free Survival ◽  
Ecog Performance Status ◽  
Cox Models ◽  
Multicenter Observational Study

3540 Background: It is unclear which drug of REG or TAS-102 should be used earlier for the patients with metastatic colorectal cancer (mCRC) who have access to both drugs. This study investigated the comparison of the efficacy between REG and TAS-102 in patients with refractory to standard chemotherapies. Methods: The clinical data of patients who were treated with REG or TAS-102 among these drugs naive mCRC patients between Jun 2014 and Sep 2015 were retrospectively delivered from 24 institutions of Japanese Society for Cancer of the Colon and Rectum (JSCCR). The primary endpoint was overall survival (OS). Propensity score (PS) was calculated with a logistic regression, in which using baseline parameters were included. Two methods, adjusted and matched analysis, to take propensity score were used. The clinical outcomes were evaluated with Kaplan-Meier method and Cox models based on PS adjustment and matching. Results: Total of 589 patients were enrolled and 550 patients (223 patients in the REG group and 327 patients in the TAS-102 group) met criteria for inclusion in the analysis. The results from PS adjusted analyses showed that OS was similar between the two groups (HR of TAS-102 to REG, 0.96; 95% confidence interval, 0.78–1.18). There were also no statistically significant differences between two groups for progression-free survival (HR 0.94) and time to ECOG Performance status≥2 (HR 1.00), expect for time to treatment failure (HR 0.81; P = 0.025). In the subgroup analysis, REG showed favorable survival compared with TAS-102 in the age of < 65 years patients and unfavorable survival in ≥65 years patients (P for interaction = 0.012). In the PS matched sample (174 patients in each group), the clinical outcomes were similar to the results of the PS adjusted analysis. Conclusions: Although REG and TAS-102 showed a similar efficacy in mCRC patients with refractory to standard chemotherapies, the choice of the drug by age might affect the survival. Supported by JSCCR. Clinical trial information: UMIN000020416

scholarly journals 1106 Timing of Free Flap Reconstruction in Sarcoma Patients

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A T Misky ◽  
S Williams ◽  
A Woollard
Keyword(s):  
Free Flap ◽  
Negative Impact ◽  
Trauma Surgery ◽  
Surgical Reconstruction ◽  
Complication Rates ◽  
Tissue Destruction ◽  
Microsurgical Reconstruction ◽  
Operative Complications ◽  
Extremity Reconstruction ◽  
Post Operative Complications

Abstract Aim In 1986 Godina reported that microsurgical reconstruction of traumatic wounds in the extremities undertaken with &gt;72-hour delay caused significant tissue damage, hampering the microsurgical reconstruction and significantly increasing complication rates. It is our opinion that surgical treatment of sarcoma in the extremity is comparable to trauma surgery, given the extent of tissue destruction. The nature of sarcoma management often means that performing definitive reconstruction within 72 hours is not possible. We analyse the outcomes of our ‘delayed’ extremity reconstruction. Method We performed a retrospective analysis of 52 consecutive cases of free flap extremity reconstruction following sarcoma excision. Data was analysed for time from resection to reconstruction, significant patient demographics, details of the flap and post-operative complications. Results Between March 2017 and December 2020, we performed 52 free flaps for sarcoma reconstruction in the extremities. Mean time to reconstruction was 28 days (Median 15 days, Range: 0-316 days), with two reconstructions within 72 hours of excision. 9 patients had neoadjuvant chemo- or radiotherapy. Three patients had significant post-operative complications; two flaps failed intra-operatively (3.8%) and one patient (1.9%) experienced wound infection. Conclusions Godina’s study demonstrated the negative impact of delaying surgical reconstruction in the traumatised extremity, with a 12% failure and 17.5% infection rate in delayed reconstruction (72 hours to 3 weeks). Our results show that with advancements in microsurgical techniques and physiological optimization, it is possible to safely and successfully undertake delayed (&gt;72 hours) microsurgical extremity reconstruction in sarcoma patients and achieve low flap failure and infection rates.

scholarly journals The Impact of Multidisciplinary Team Approach on Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis

2021 ◽  
Vol 11 (12) ◽  
pp. 1313
Author(s):  
Hao-Chien Hung ◽  
Po-Jung Hsu ◽  
Ting-Chang Chang ◽  
Hung-Hsueh Chou ◽  
Kuan-Gen Huang ◽  
...  
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
P Value ◽  
Team Approach ◽  
Complication Rates ◽  
Operative Complication ◽  
Operative Complications ◽  
Post Operative Complications

Background: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS–HIPEC) is a therapeutic approach used to achieve curative treatment in intra-abdominal malignancy with peritoneal carcinomatosis (PC). However, it is a complicated procedure with high post-operative complication rates. Thus, we analyzed our preliminary data to establish whether multidisciplinary teamwork (MDT) implementation is beneficial for CRS–HIPEC outcomes. Method: A series of 132 consecutive patients with synchronous or recurrent PC secondary to gastrointestinal or gynecologic cancer who received CRS–HIPEC operation between May 2015 and September 2017 were included. Ninety-nine patients were categorized into the MDT group, with the 33 other patients into the non-MDT group. Results: The mean PCI score was 16.3 ± 8.8. Patients in the MDT group more often presented a higher PCI score (p value = 0.038). Regarding CRS completeness (CCR 0–1), it was distributed 81.8% and 57.6% in the MDT and the non-MDT group, respectively (p value = 0.005). Although post-operative complications were common (n = 62, 47.0%), post-operative complication rates did not differ between the two groups. The cumulative OS survival rate at the first year was 75.5%. Older age (p = 0.030, HR = 4.58, 95% CI = 1.16–18.10), ECOG 2 (p = 0.030, HR = 6.41, 95% CI = 1.20–34.14), and incomplete cytoreduction (p = 0.048, HR = 2.79, 95% CI = 1.04–8.27) were independent prognostic factors for survival. Conclusions: Our experience suggests that the CRS–HIPEC performed under MDT cooperation may result in higher complete cytoreduction rates without increasing post-operative complications and hospital mortalities.

Impact of malnutrition on surgical outcome of patients with ovarian cancer: Results of a prospective study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16564-e16564
Author(s):  
P. Skowronek ◽  
M. Kuhberg ◽  
F. Chen ◽  
J. Schwarz ◽  
W. Lichtenegger ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Surgical Outcome ◽  
Nutritional Assessment ◽  
Recurrent Disease ◽  
Performance Status ◽  
Postoperative Mortality ◽  
Nutritional Risk ◽  
Tumor Spread ◽  
Operative Complications ◽  
Post Operative Complications

e16564 Background: The purpose of this study was to examine an influence of poor nutritional status on surgical outcome in patients with ovarian cancer. Methods: Data from 152 consecutive patients with histologically confirmed ovarian cancer were prospectively analyzed. Overall 79 suffered from primary and 73 from recurrent disease. All patients received a systematic nutritional assessment prior to cytoreductive surgery and postoperative all complications were analyzed in detail. The Nutritional Risk Score (NRS-2002) was used to identify patients at high nutritional risk (NRS≥3). Intraoperatively, a standardized documentation script (IMO) was applied including tumor localization, surgical interventions, and postoperative residual tumor mass. Results: 29 patients (19%) were classified as malnourished, including 19 (24%) with primary and 10 (14%) with recurrent disease. These patients showed a significantly poorer performance status preoperatively compared to patients with NRS<3 (p < 0.05), which was assessed according to the American Society of Anesthesiologists (ASA). Also an intra-operatively documented tumor spread was significantly more extended in group with NRS≥3 than among patients with NRS<3 (p < 0.05). In malnourished patients complete resection rate was significantly decreased (31% vs. 69%, p < 0.001) and they required more often a colo- or ileostoma (17% vs. 6%, p = 0.041). Malnourished patients suffered more often from post-operative complications (62% vs. 37%, p < 0.05), especially infectious like pneumonia or sepsis. All postoperative mortality events (3 cases) occurred in the malnourished group. Conclusions: Malnourished ovarian cancer patients have significantly more often post-operative complications. They suffer from more extended tumor spread and were less frequently postoperatively tumor-free. Based on our results further prospective trials of preoperative nutritional therapy to improve surgical outcome are warranted. No significant financial relationships to disclose.

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