Sex Differences Between cT4b and pT4b Rectal Cancers

Abstract We retrospectively evaluated rectal cancer surgery cases in which resection had been performed for invasion of other organs in terms of pathologic findings from the viewpoint of sex differences. We enrolled 61 consecutive patients with rectal cancer who had undergone curative surgery with resection of invaded adjacent organs. We investigated invasion of adjacent organs in terms of pathologic findings according to sex differences. Among males, 4 cases (13.8%) had received combined radical resections of more than 2 organs, while the number of such female cases was 15 (46.9%). The difference between males and females was statistically significant (P = 0.006). Among male cases, histopathologic invasion was present in 4 (13.8%), while 9 female cases (28.1%) showed this feature. Nevertheless, there was not a statistically significant difference between males and females (P = 0.08); the rate in females was roughly twice that in males. No significant difference was recognized in the overall survival rates between males and females, but more females than males experienced local recurrence. In cases with rectal cancer invading neighboring organs, the effect of the invasion must be carefully determined, and the most appropriate operative approach selected accordingly.

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Survival in colon and rectal cancers in Finland and Sweden through 50 years

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2021-000644 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000644

Author(s):

Kari Hemminki ◽

Asta Försti ◽

Akseli Hemminki

Keyword(s):

Rectal Cancer ◽

Colon Cancer ◽

Cancer Survival ◽

Survival Rates ◽

Positive Development ◽

Old Patients ◽

Colon And Rectal Cancer ◽

Rectal Cancers ◽

The Difference ◽

Survival Studies

ObjectivesGlobal survival studies have shown favourable development in colon and rectal cancers but few studies have considered extended periods or covered populations for which medical care is essentially free of charge.DesignWe analysed colon and rectal cancer survival in Finland and Sweden over a 50-year period (1967–2016) using data from the Nordcan database. In addition to the standard 1-year and 5-year survival rates, we calculated the difference between these as a novel measure of how well survival was maintained between years 1 and 5.ResultsRelative 1-year and 5-year survival rates have developed favourably without major shifts for men and women in both countries. For Finnish men, 1-year survival in colon cancer increased from 50% to 82%, and for rectal cancer from 62% to 85%. The Swedish survival was a few per cent unit better for 1-year survival but for 5-year survival the results were equal. Survival of female patients for both cancers was somewhat better than survival in men through 50 years. Overall the survival gains were higher in the early compared with the late follow-up periods, and were the smallest in the last 10 years. The difference between 1-year and 5-year survival in colon cancer was essentially unchanged over the 50-year period while in rectal cancer there was a large improvement.ConclusionsThe gradual positive development in survival suggests a contribution by many small improvements rather than single breakthroughs. The improvement in 5-year survival in colon cancer was almost entirely driven by improvement in 1-year survival while in rectal cancer the positive development extended to survival past year 1, probably due to successful curative treatments. The current challenges are to reinvigorate the apparently stalled positive development and to extend them to old patients. For colon cancer, survival gains need to be extended past year 1 of diagnosis.

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Robotic colorectal surgery: more than a fantastic toy?

Innovative Surgical Sciences ◽

10.1515/iss-2017-0046 ◽

2018 ◽

Vol 3 (1) ◽

pp. 65-68 ◽

Cited By ~ 1

Author(s):

James W.T. Toh ◽

Kevin Phan ◽

Seon-Hahn Kim

Keyword(s):

Rectal Cancer ◽

Colorectal Surgery ◽

Da Vinci Surgical System ◽

Current Evidence ◽

Rectal Cancer Surgery ◽

Cancer Trial ◽

Robotic Colorectal Surgery ◽

Significant Difference ◽

Meta Analyses ◽

Laparoscopic Assisted

AbstractThere has been a rapid rise in the number of robotic colorectal procedures worldwide since the da Vinci Surgical System robotic technology was approved for surgical procedures in the year 2000. Several recent meta-analyses and systematic reviews have shown a significant difference in outcomes between robotic and laparoscopic rectal cancer surgery. However, these results from pooled data have not been supported by the initial results reported from the Robotic assisted versus laparoscopic assisted resection for rectal cancer trial. In this article, we examine the current evidence for robotic colorectal surgery, assess its features and functionality, evaluate its learning curve and provide our perspective on its future.

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Quantitative electroencephalography as a tool for objective neurophysiological seizure diagnosis: A retrospective study

Indian Journal of Medical Sciences ◽

10.25259/ijms_160_2020 ◽

2020 ◽

Vol 0 ◽

pp. 1-6

Author(s):

Rajesh Kumar ◽

Tribhuwan Kumar ◽

Kamlesh Jha ◽

Yogesh Kumar

Keyword(s):

Energy Level ◽

Matched Control ◽

Age Groups ◽

Quantitative Electroencephalography ◽

Beta Band ◽

Significant Difference ◽

Males And Females ◽

The Mean ◽

The Difference ◽

Electrical Activities

Objectives: Seizure is the fourth most common neurological disorder in the world; it affects all age groups with equal possibility of occurrence in both males and females. Many antiepileptic drugs are available today, but its diagnosis is challenging. The present study attempted to see if seizure activities could be predicted by analyzing the pre-seizure electrical activities. The prediction may help in taking preventive measures appropriately beforehand in the individuals with seizure proneness. Material and Methods: We selected 11 generalized seizure patients and 19 control patients out of total 115 patients referred for electro-diagnostics for various reasons. EEG of the subjects recorded, segmented as per protocol, and analyzed using MATLAB and EEGLAB tools. Results: The mean energy level in alpha and beta band of the study subject was significantly lower (P = 0.04 and 0.004, respectively) as compared to the age matched control subjects. Theta and delta bands did not show any significant difference between the groups. The difference between the pre- and post-electrical seizure energy and entropy was statistically insignificant. Conclusion: The study shows that the energy level remains low in the seizure patients in the alpha and beta bands. This further goes down when electrophysiological seizure activities starts. The randomness or entropy does not alter significantly among the seizure subjects in comparison to non-seizure subjects.

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ISR for T1-2 Low Rectal Cancer: A Japanese Approach

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0040-1714240 ◽

2020 ◽

Vol 33 (06) ◽

pp. 361-365

Author(s):

Masaaki Ito

Keyword(s):

Rectal Cancer ◽

Local Recurrence ◽

Recurrence Rate ◽

Phase Ii ◽

Local Recurrence Rate ◽

Anal Verge ◽

Low Rectal Cancer ◽

Rectal Cancer Surgery ◽

Rectal Cancers ◽

Anal Preservation

AbstractThe evolution over the past 20 years of anal preservation in rectal cancer surgery has been truly remarkable. Intersphincteric resection (ISR) reported by Schiessel in 1994 in Australia has been shown to enable anal preservation even for cancers quite close to the anus. In Japan, ISR via the detachment of the anal canal between the internal and external sphincters and excision of the internal sphincter first began to be practiced in the latter half of 1990. A multicenter Phase II trial of ISR in Japan suggested that 70% of the cases had relatively good function with less than 10 points of Wexner score but around 10% had severe incontinence that would not be improved for long term. The primary end point of the clinical study, 3-year local recurrence rate, was 13.2% across the overall cohort (T1, 0%; T2, 6.9%; and T3, 21.6%). When ISR is performed on T1/T2 rectal cancers, sufficient circumferential resection margin can be obtained even without preoperative chemoradiotherapy, and local recurrence rate was acceptably low. Based on these evidences, ISR is a currently important, standard treatment option among anal-preserving surgeries for T1/T2 low-lying rectal cancers. In Japan, a feasibility study (LapRC trial) of laparoscopic ISR on Stage 0 and Stage 1 low rectal cancer showed excellent outcomes. A prospective Phase II clinical trial targeting low rectal cancers within 5 cm from the anal verge (ultimate trial) is being performed and awaiting the results in near future.

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Treatment of advanced Hodgkin's disease with chemotherapy--comparison of MOPP/ABV hybrid regimen with alternating courses of MOPP and ABVD: a report from the National Cancer Institute of Canada clinical trials group.

Journal of Clinical Oncology ◽

10.1200/jco.1997.15.4.1638 ◽

1997 ◽

Vol 15 (4) ◽

pp. 1638-1645 ◽

Cited By ~ 119

Author(s):

J M Connors ◽

P Klimo ◽

G Adams ◽

B F Burns ◽

I Cooper ◽

...

Keyword(s):

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Survival Rates ◽

Prospective Trial ◽

Treatment Center ◽

Wide Field ◽

Free Survival ◽

Significant Difference ◽

The Difference ◽

Advanced Hodgkin’S Disease

PURPOSE This randomized, prospective trial compares outcomes for patients with advanced Hodgkin's disease treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP)/doxorubicin, bleomycin, and vinblastine (ABV) hybrid regimen or alternating MOPP/doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). METHODS Three hundred one patients with advanced Hodgkin's disease were randomized to receive MOPP/ ABV hybrid regimen or alternating MOPP/ABVD after stratification for prior treatment, B symptoms, and treatment center. Eligible patients were either previously untreated and found to have stage IIIB, IVA, or IVB disease or previously treated with wide-field irradiation. Responding patients received a minimum of eight cycles of chemotherapy. Those with residual disease in a localized region received irradiation between the sixth and seventh cycle of treatment. RESULTS Response rates to the two regimens were similar. Five-year overall survival rates were 81% and 83% for MOPP/ABV hybrid and alternating MOPP/ ABVD, respectively (P = .74; 95% confidence interval [CI] for the difference, -11% to 7%). Five-year failure-free survivals were 71% and 67% for MOPP/ABV hybrid and alternating MOPP/ABVD, respectively (P = .87; 95% CI for the difference, -9% to 17%). Significantly more episodes of febrile neutropenia and stomatitis were observed with the MOPP/ABV hybrid regimen; there was no significant difference in fatal toxicity. Patients with predefined, high-quality partial responses (PR-1s) had results similar to those with complete responses (CRs). Planned subset analysis showed no significant difference in outcome between the two arms of the trial for patients with newly diagnosed disease (5-year failure-free survival rates were 70% for MOPP/ABV hybrid and 59% for alternating MOPP/ABVD; P = .180), but superiority of alternating MOPP/ABVD for patients with prior irradiation (5-year failure-free survival 94% v 73%; P = .017). CONCLUSION MOPP/ABV hybrid and alternating MOPP/ABVD regimens are equally effective for patients with advanced Hodgkin's disease.

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Prognostic Significance of Microvessel Density Determining by Endoglin in Stage II Rectal Carcinoma: A Retrospective Analysis

Gastroenterology Research and Practice ◽

10.1155/2015/504179 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Zeljko Martinovic ◽

Drazen Kovac ◽

Mia Martinovic

Keyword(s):

Rectal Cancer ◽

Survival Rates ◽

Prognostic Significance ◽

Normal Mucosa ◽

Tumor Location ◽

Integrated System ◽

Stage Ii ◽

Rank Test ◽

Adjacent Mucosa ◽

Significant Difference

Background. The role of endoglin in the Dukes B rectal cancer is still unexplored. The aim of this study was to examine the expression of endoglin (CD105) in resected rectal cancer and to evaluate the relationship between microvessels density (MVD), clinicopathological factors, and survival rates.Methods. The study included 95 primary rectal adenocarcinomas, corresponding to 67 adjacent and 73 distant normal mucosa specimens from surgical resection samples. Tumor specimens were paraffin-embedded and immunohistochemical staining for the CD105 endothelial antigen was performed to count CD105-MVD. For exact measurement of the CD105-MVD used a computer-integrated system Alphelys Spot Browser 2 was used.Results. The intratumoral CD105-MVD was significantly higher compared with corresponding adjacent mucosa (P<0.0001) and distant mucosa specimens (P<0.0001). There was no significant difference in the CD105-MVD according to patients age, gender, tumor location, grade of differentiation, histological type, depth of tumor invasion, and tumor size. The overall survival rate was significantly higher in the low CD105-MVD group of patients than in the high CD105-MVD group of patients (log-rank test,P=0.0406).Conclusion. CD105-assessed MVD could help to identify patients with possibility of poor survival in the group of stage II RC.

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Sex Differences in Adults on a Test of Logical Reasoning

Psychological Reports ◽

10.2466/pr0.1956.2.3.227 ◽

1956 ◽

Vol 2 (3) ◽

pp. 227-230

Author(s):

Antonia Bell Morgan

Keyword(s):

Sex Differences ◽

Logical Reasoning ◽

Formal Logic ◽

Government Employment ◽

Significant Difference ◽

Males And Females ◽

The Mean

The Morgan Test of Logical Reasoning, which is entirely verbal in form, was given to 133 males and 35 females. All Ss were in their 20s and applicants for government employment. All had the BA or BS degree but no other, and none had had any training in formal logic. No significant difference was found between the mean scores of males and females on this test, nor between the distribution and variation of scores.

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The effect of rectal washout on local recurrence following rectal cancer surgery

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0202 ◽

2018 ◽

Vol 100 (2) ◽

pp. 146-151 ◽

Cited By ~ 1

Author(s):

SR Moosvi ◽

K Manley ◽

J Hernon

Keyword(s):

Rectal Cancer ◽

Local Recurrence ◽

Anterior Resection ◽

High Volume ◽

Conclusive Evidence ◽

Rectal Cancer Surgery ◽

Single Institution ◽

Recurrence Rates ◽

Rectal Washout ◽

Significant Difference

Introduction Local recurrence after surgery for rectal cancer is associated with significant morbidity and debilitating symptoms. Intraoperative rectal washout has been linked to a reduction in local recurrence but there is no conclusive evidence. The aim of this study was to evaluate whether performing rectal washout had any effect on the incidence of local recurrence in patients undergoing anterior resection for rectal cancer in the context of the current surgical management. Methods A total of 395 consecutive patients who underwent anterior resection with or without rectal washout for rectal cancer between January 2003 and July 2009 at a high volume single institution were analysed retrospectively. A standardised process for performing washout was used and all patients had standardised surgery in the form of total mesorectal excision. Neoadjuvant and adjuvant therapy was used on a selected basis. Patients were followed up for five years and local recurrence rates were compared in the two groups. Results Of the 395 patients, 297 had rectal washout and 98 did not. Both groups were well matched with regard to various important clinical, operative and histopathological characteristics. Overall, the local recurrence rate was 5.3%. There was no significant difference in the incidence of local recurrence between the washout group (5.7%) and the no washout group (4.1%). Conclusions Among our cohort of patients, there was no statistical difference in the incidence of local recurrence after anterior resection with or without rectal washout. This suggests that other factors are more significant in the development of local recurrence.

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Sex Differences in Feedback: Effects on Rod-and-Frame Performance

Perceptual and Motor Skills ◽

10.2466/pms.1979.48.3c.1279 ◽

1979 ◽

Vol 48 (3_suppl) ◽

pp. 1279-1285 ◽

Cited By ~ 4

Author(s):

G. Erdos

Keyword(s):

Sex Differences ◽

Feedback Effects ◽

Starting Position ◽

Significant Difference ◽

Males And Females ◽

Rod And Frame Test ◽

Rod And Frame

It has been demonstrated that feedback is effective in changing rod-and-frame performance for women if given the opportunity to adjust the rod to the vertical repeatedly from the same starting position. It is also shown that the significant difference between males and females in the Rod-and-frame Test is carried by the large difference in the initial tilting position.

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Neutrophil-to-Lymphocyte Ratio is a Prognostic Predictive Factor for Local Advanced Lower Rectal Cancer Treated with Curative Surgical Treatment after Neoadjuvant Chemoradiotherapy: A Single-Center Retrospective Cohort Study

10.21203/rs.3.rs-386980/v1 ◽

2021 ◽

Author(s):

Ryosuke Nakagawa ◽

Shimpei Ogawa ◽

Yuji Inoue ◽

Takeshi Ohki ◽

Yoshiko Bamba ◽

...

Keyword(s):

Rectal Cancer ◽

Univariate Analysis ◽

Locally Advanced ◽

Neoadjuvant Chemoradiotherapy ◽

Operation Time ◽

Neutrophil To Lymphocyte Ratio ◽

Lower Rectal Cancer ◽

Curative Surgery ◽

Lymphocyte Ratio ◽

Significant Difference

Abstract Background: The neutrophil-to-lymphocyte ratio (NLR) correlates with relapse-free survival (RFS) and may be a predictor of recurrence in patients after curative surgery for colorectal cancer. This study aimed to analyze the long-term oncological outcomes of locally advanced lower rectal cancer treated with curative surgery after neoadjuvant chemoradiotherapy (nCRT) to examine the prognostic value of the NLR and to evaluate the fluctuation of pre- and post-CRT NLR as recurrence risk factors.Methods: Fifty-two patients who underwent curative surgery were enrolled between 2009 and 2016. A cut-off pre-CRT NLR of 3.20 was used based on receiver-operating characteristic curve analysis. The primary outcome was RFS. Factors influencing recurrence after treatment according to fluctuations between the pre- and post-CRT NLR were also analyzed.Results: Univariate analysis was performed using 17 clinicopathological factors thought to affect RFS. A significant difference was found in the pre-CRT NLR (hazard ratio [HR]: 7.626, 95% confidence interval [CI]: 2.760-21.06, p<0.0001), operation time (HR: 2.949, 95% CI: 1.137-7.646, p=0.0261), and pathological T stage (HR: 8.342, 95% CI: 2.458-28.306 p=0.0007). RFS according to the pre-CRT NLR using Kaplan–Meier analysis showed that the group with pre-CRT ≥3.20 had a lower 5-year RFS (p=0.001). A lower pre-CRT NLR resulted in a significantly higher recurrence rate, regardless of the increase or decrease in the pre- and post-CRT NLR.Conclusions: The pre-CRT NLR may be a predictor of prognosis in patients with locally advanced lower rectal cancer after nCRT.

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