Effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications in elderly patients with colorectal cancer: A prospective study

Purpose: We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.Methods: Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.Results: Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).Conclusion: This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

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Risk Factors for Postoperative Complications in Elderly After Colorectal Cancer Resection

International Surgery ◽

10.9738/intsurg-d-15-00255.1 ◽

2017 ◽

Vol 102 (7-8) ◽

pp. 299-306 ◽

Cited By ~ 1

Author(s):

Daisuke Kyuno ◽

Kazuaki Sasaki ◽

Keisuke Ohno ◽

Ai Konno ◽

Takeshi Murakami ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Logistic Regression ◽

Laparoscopic Surgery ◽

Postoperative Complications ◽

Elderly Patients ◽

Postoperative Delirium ◽

Morbidity And Mortality ◽

Cancer Resection ◽

Colorectal Cancer Resection

This study aimed to assess perioperative morbidity and mortality in elderly patients following colorectal cancer resection and to investigate risk factors for postoperative complications. This study reviewed 697 consecutive patients who underwent elective colorectal cancer resection between 2005 and 2013 at our institution. Patients were divided into 3 groups according to their age: ≤74 (n = 420), 75 to 89 (n = 261), and ≥90 years (n = 16). Clinical findings, morbidity, and mortality were compared among these groups. Univariate and multivariate logistic regression analyses were performed with clinically relevant variables for the complications that increased with aging. Postoperative delirium and pneumonia showed significant increases with aging. There were no significant differences in mortality and morbidity among the 3 groups, except for the 2 aforementioned diseases. Multiple logistic regression analysis showed that dementia and laparoscopic surgery were independent determinants of postoperative delirium and that age and American Society of Anesthesiologists (ASA) score were independent risk factors for postoperative pneumonia. Dementia, high ASA score, and age were the risk factors for higher postoperative morbidity in elderly patients. Our results demonstrated the effectiveness of laparoscopic surgery for the prevention of postoperative delirium after colorectal resection.

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FOLFOX4 in the treatment of metastatic colorectal cancer in elderly patients: A prospective study

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2010.02.006 ◽

2011 ◽

Vol 52 (1) ◽

pp. 89-93 ◽

Cited By ~ 8

Author(s):

Massimiliano Berretta ◽

Alessandro Cappellani ◽

Francesco Fiorica ◽

Guglielmo Nasti ◽

Sergio Frustaci ◽

...

Keyword(s):

Colorectal Cancer ◽

Elderly Patients ◽

Prospective Study ◽

Metastatic Colorectal Cancer ◽

A Prospective Study

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Microvascular decompression for elderly patients with trigeminal neuralgia: a prospective study and systematic review with meta-analysis

Yearbook of Neurology and Neurosurgery ◽

10.1016/j.yneu.2011.04.055 ◽

2011 ◽

Vol 2011 ◽

pp. 244-245

Author(s):

P.A. House

Keyword(s):

Systematic Review ◽

Trigeminal Neuralgia ◽

Elderly Patients ◽

Prospective Study ◽

Microvascular Decompression ◽

Meta Analysis ◽

A Prospective Study

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A prospective study of FOLFOX4 regimen's tolerance in the treatment of metastatic colorectal cancer

Zeitschrift für Gastroenterologie ◽

10.1055/s-2005-869810 ◽

2005 ◽

Vol 43 (05) ◽

Author(s):

É Végh ◽

Á Petrányi ◽

K Tamas ◽

Z Szűcs ◽

G Bodoky

Keyword(s):

Colorectal Cancer ◽

Prospective Study ◽

Metastatic Colorectal Cancer ◽

A Prospective Study

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Baseline and Kinetic Circulating Tumor Cell Counts Are Prognostic Factors in a Prospective Study of Metastatic Colorectal Cancer

Diagnostics ◽

10.3390/diagnostics11030502 ◽

2021 ◽

Vol 11 (3) ◽

pp. 502

Author(s):

Virgílio Souza e Silva ◽

Emne Ali Abdallah ◽

Angelo Borsarelli Carvalho de Brito ◽

Alexcia Camila Braun ◽

Milena Shizue Tariki ◽

...

Keyword(s):

Colorectal Cancer ◽

Drug Resistance ◽

Prospective Study ◽

Metastatic Colorectal Cancer ◽

Clinical Outcomes ◽

Predictive Biomarkers ◽

Multi Drug Resistance ◽

Cell Counts ◽

Potential Clinical Benefit ◽

A Prospective Study

The discovery of predictive biomarkers in metastatic colorectal cancer (mCRC) is essential to improve clinical outcomes. Recent data suggest a potential role of circulating tumor cells (CTCs) as prognostic indicators. We conducted a follow-on analysis from a prospective study of consecutive patients with mCRC. CTC analysis was conducted at two timepoints: baseline (CTC1; before starting chemotherapy), and two months after starting treatment (CTC2). CTC isolation/quantification were completed by ISET® (Rarecells, France). CTC expressions of drug resistance-associated proteins were evaluated. Progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan–Meier method. Seventy-five patients were enrolled from May 2012 to May 2014. A CTC1 cut-off of >1.5 CTCs/mL was associated with an inferior median OS compared to lower values. A difference of CTC2−CTC1 > 5.5 CTCs/mL was associated with a reduced median PFS. By multivariate analysis, CTC1 > 1.5 CTCs/mL was an independent prognostic factor for worse OS. Multi-drug resistance protein-1 (MRP-1) expression was associated with poor median OS. CTC baseline counts, kinetics, and MRP-1 expression were predictive of clinical outcomes. Larger studies are warranted to explore the potential clinical benefit of treating mCRC patients with targeted therapeutic regimens guided by CTC findings.

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Tumor Tissue MIR92a and Plasma MIRs21 and 29a as Predictive Biomarkers Associated with Clinicopathological Features and Surgical Resection in a Prospective Study on Colorectal Cancer Patients

Journal of Clinical Medicine ◽

10.3390/jcm9082509 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2509

Author(s):

Masahiro Fukada ◽

Nobuhisa Matsuhashi ◽

Takao Takahashi ◽

Nobuhiko Sugito ◽

Kazuki Heishima ◽

...

Keyword(s):

Colorectal Cancer ◽

Prospective Study ◽

Surgical Resection ◽

Tumor Tissue ◽

Lymphatic Invasion ◽

Clinicopathological Features ◽

Stage Iii ◽

Sample Type ◽

Significant Difference ◽

A Prospective Study

Cancer-related microRNAs (miRNAs) are emerging as non-invasive biomarkers for colorectal cancer (CRC). This study aimed to analyze the correlation between the levels of tissue and plasma miRNAs and clinicopathological characteristics and surgical resection. This study was a prospective study of CRC patients who underwent surgery. Forty-four sample pairs of tissue and plasma were analyzed. The miRNA levels were evaluated by RT-qPCR. The level of tumor tissue MIR92a showed a significant difference in CRC with lymph node metastasis, stage ≥ III, and high lymphatic invasion. In preoperative plasma, there were significant differences in CRC with stage ≥ III (MIR29a) and perineural invasion (MIR21). In multivariate analysis of lymphatic invasion, the levels of both preoperative plasma MIR29a and tumor tissue MIR92a showed significant differences. Furthermore, in cases with higher plasma miRNA level, the levels of plasma MIRs21 and 29a were significantly decreased after the operation. In this study, there were significant differences in miRNAs levels with respect to the sample type, clinicopathological features, and surgical resection. The levels of tumor tissue MIR92a and preoperative plasma MIR29a may have the potential as a biomarker for prognosis. The plasma MIRs21 and 29a level has the potential to be a predictive biomarker for treatment efficacy.

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