Retrospective analysis of clinical and pathologic risk factors in liver resection for hepatic colorectal metastases

Abstract Background The impact of body compositions on surgical results is controversially discussed. This study examined whether visceral obesity, sarcopenia or sarcopenic obesity influence the outcome after hepatic resections of synchronous colorectal liver metastases. Methods Ninety-four consecutive patients with primary hepatic resections of synchronous colorectal metastases were identified from a single center database between January 2013 and August 2018. Patient characteristics and 30-day morbidity were retrospectively analyzed. Body fat and skeletal muscle were calculated by planimetry from single-slice CT images at the level of L3. Results Fifty-nine patients (62.8%) underwent minor hepatectomies, and 35 patients underwent major resections (37.2%). Postoperative complications occurred in 60 patients (62.8%) including 35 patients with major complications (Clavien–Dindo grade III–V). The mortality was nil at 30 days and 2.1% at 90 days. The body mass index showed no influence on postoperative outcomes (p = 1.0). Visceral obesity was found in 66 patients (70.2%) and was significantly associated with overall and major complication rates (p = .002, p = .012, respectively). Sarcopenia was observed in 34 patients (36.2%) without a significant impact on morbidity (p = .461), however, with longer hospital stay. Sarcopenic obesity was found in 18 patients (19.1%) and was significantly associated with postoperative complications (p = .014). Visceral obesity, sarcopenia and sarcopenic obesity were all identified as significant risk factors for overall postoperative complications. Conclusion Visceral obesity, sarcopenic obesity and sarcopenia are independent risk factors for overall complications after resections of CRLM. Early recognition of extremes in body compositions could prompt to perioperative interventions and thus improve postoperative outcomes.

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MULTICENTER RETROSPECTIVE ANALYSIS OF RISK FACTORS FOR MORTALITY OF COVID‐19 INFECTION IN PATIENTS WITH LYMPHOMA

Hematological Oncology ◽

10.1002/hon.197_2880 ◽

2021 ◽

Vol 39 (S2) ◽

Author(s):

J. Kořen ◽

K. Steinerová ◽

A. Janíková ◽

D. Belada ◽

B. Hájková ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Analysis

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Clinical Study of Postoperative Bleeding after Tonsillectomy in 497 Cases

International Journal of Practical Otolaryngology ◽

10.1055/s-0041-1723787 ◽

2021 ◽

Vol 4 (01) ◽

pp. e17-e20

Author(s):

Takeshi Tanaka ◽

Kenji Ishii ◽

Kyoko Matsumoto ◽

Koushirou Miura ◽

Ayako Kihara ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Clinical Study ◽

General Anesthesia ◽

Retrospective Analysis ◽

Body Mass ◽

Smoking Habit ◽

Postoperative Bleeding ◽

Operation Time ◽

History Of

AbstractWe conducted a retrospective analysis of 497 patients who underwent tonsillectomy at Kamio Memorial Hospital from September 2015 to August 2018. A total of 35 cases (7.0%) developed postoperative bleeding and three cases (0.6%) needed a second operation under general anesthesia to stop the bleeding. Postoperative bleeding most frequently occurred between 24 hours and 6 days after the operation. The incidence of postoperative bleeding was significantly higher in males and in patients aged 20 to 39 years old. The operation time, body mass index, smoking habit, and history of hypertension were not identified as clinical risk factors for bleeding after tonsillectomy in this study.

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Circulating tumor cell-related transcripts in blood as prognostic biomarkers of early recurrence after liver resection for colorectal metastases

The International Journal of Biological Markers ◽

10.1177/1724600819849438 ◽

2019 ◽

Vol 34 (3) ◽

pp. 269-275

Author(s):

Felice Giuliante ◽

Elena Panettieri ◽

Francesco Ardito ◽

Agostino De Rose ◽

Krizia Pocino ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Resection ◽

Tumor Cell ◽

Carcinoembryonic Antigen ◽

Growth Factor Receptor ◽

Predictive Biomarker ◽

Circulating Tumor Cell ◽

Early Recurrence ◽

Colorectal Metastases

Background: Several prognostic factors were proposed to improve early detection of recurrence after liver resection of metastases of colorectal cancer. Circulating tumor cell-related transcripts were evaluated in colorectal cancer patients with conflicting results. The aim of this study was to investigate usefulness of carcinoembryonic antigen CAM5, epidermal growth factor receptor, and ERCC1 transcripts in the bloodstream as predictive factors of recurrence in patients who underwent liver resection for metastases of colorectal cancer. Methods: Peripheral blood was collected from 29 patients at the time of the colorectal cancer liver metastasis resection, and from 25 normal controls. Follow-up draws (FUDs) were also performed at 30 days, and 3 and 12 months since surgery. On each sample, carcinoembryonic antigen CAM5, ERCC1, and GAPDH mRNAs were examined by quantitative reverse transcription (qRT). Results: Carcinoembryonic antigen transcript levels were linearly correlated to the number of spiked cells (qRT analytical limit = five cells). Among 29 patients (20 M/9 F; mean age 63 years (range 32–79), highly significant levels of carcinoembryonic antigen, if compared to the baseline, were detected in those relapsing after surgery ( P <0.05). The main differences were between the 1st- and 12th-month FUDs. Significantly higher levels of carcinoembryonic antigen were also detected in patients who died from disease progression during the follow-up (as evaluated at 30 days and 90 days FUDs). Conclusions: Blood carcinoembryonic antigen-mRNA absolute copy number overtime variation can represent a valid early predictor of relapse after liver resection in colorectal liver metastases patients. Prospective studies, in the context of large clinical trials, will provide further data to also qualify ERCC1 as a predictive biomarker for decisions on therapeutic strategies.

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