<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Clinical predictors of death and survival in surgical treatme...<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Clinical predictors of death and survival in surgical treatment </span><span style="font-family:Verdana;">of colon cancer are easily confounded by the modern adjuvant and</span><span style="font-family:Verdana;"> neo-adjuvant chemotherapy. This study focuses on lethality and survival during implementation of ultra-radical surgery for colonic cancer prior to multimodal therapy. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Retrospective observational follow-up study of 824 consecutive, unselected patients resected for Stage I, II, III and IV colon cancer from 1990 until 2000 at one tertiary centre, with a median follow-up of 45 months (0 - 202 months). Predictors for death were assessed by Cox regression analyses and log-rank test. The cause of death was obtained from the Norwegian Cause of Death Registry. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The relative survival rates were 86.3%, 71.9%, 50.3% and 6.6% in Stage I, II, III and IV, respectively. In 28.7% </span><span style="font-family:Verdana;">of the patients, the cause of death was other than colorectal cancer recur</span><span style="font-family:Verdana;">rence. </span><span style="font-family:Verdana;">The adjusted Cox regression model showed that higher age (1.04 (95% CI:</span><span style="font-family:Verdana;"> 1.03;1.05)), male gender (1.37 (1.14;1.66)), emergency surgery (1.52 (1.21;</span><span style="font-family:Verdana;">1.93)), left vs. right hemicolectomy (1.39 (1.03;1.87)), and perioperative</span><span style="font-family:Verdana;"> blood transfusion (1.25 (1.01;1.55)) were predictors of reduced survival. Health without known comorbidity (0.71 (0.58;0.88)), D2 versus D1 lymph node dissection (0.66 (0.53;0.83)) and tumour Stage I, II, III versus Stage IV 0.10 (0.06;0.16), 0.14 (0.11;0.19), 0.23 (0.18;0.30) were associated with prolonged survival. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> In 28.7% of the patients, the cause of death was other than colorectal cancer recurrence. Age, sex, comorbidity, emergency resec</span><span style="font-family:Verdana;">tion, lack of lymph node dissection, tumour stage, and preoperative blood</span><span style="font-family:Verdana;"> transfusions are all significant predictors for reduced survival after surgery for colon cancer.</span></span>展开更多
AIM: To analyze the predictive factors for lymph node metastasis (LNM) in early gastric cancer (EGC). METHODS: Data from patients surgically treated for gastric cancers between January 1994 and December 2007 were retr...AIM: To analyze the predictive factors for lymph node metastasis (LNM) in early gastric cancer (EGC). METHODS: Data from patients surgically treated for gastric cancers between January 1994 and December 2007 were retrospectively collected. Clinicopathological factors were analyzed to identify predictive factors for LNM. RESULTS: Of the 2936 patients who underwent gas-trectomy and lymph node dissection, 556 were diag-nosed with EGC and included in this study. Among these, 4.1% of patients had mucosal tumors (T1a) with LNM while 24.3% of patients had submucosal tumorswith LNM. Univariate analysis found that female gen-der, tumors ≥ 2 cm, tumor invasion to the submucosa, vascular and lymphatic involvement were significantly associated with a higher rate of LNM. On multivariate analysis, tumor size, lymphatic involvement, and tumor with submucosal invasion were associated with LNM. CONCLUSION: Tumor with submucosal invasion, size ≥ 2 cm, and presence of lymphatic involvement are predictive factors for LNM in EGC.展开更多
文摘<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Clinical predictors of death and survival in surgical treatment </span><span style="font-family:Verdana;">of colon cancer are easily confounded by the modern adjuvant and</span><span style="font-family:Verdana;"> neo-adjuvant chemotherapy. This study focuses on lethality and survival during implementation of ultra-radical surgery for colonic cancer prior to multimodal therapy. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Retrospective observational follow-up study of 824 consecutive, unselected patients resected for Stage I, II, III and IV colon cancer from 1990 until 2000 at one tertiary centre, with a median follow-up of 45 months (0 - 202 months). Predictors for death were assessed by Cox regression analyses and log-rank test. The cause of death was obtained from the Norwegian Cause of Death Registry. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The relative survival rates were 86.3%, 71.9%, 50.3% and 6.6% in Stage I, II, III and IV, respectively. In 28.7% </span><span style="font-family:Verdana;">of the patients, the cause of death was other than colorectal cancer recur</span><span style="font-family:Verdana;">rence. </span><span style="font-family:Verdana;">The adjusted Cox regression model showed that higher age (1.04 (95% CI:</span><span style="font-family:Verdana;"> 1.03;1.05)), male gender (1.37 (1.14;1.66)), emergency surgery (1.52 (1.21;</span><span style="font-family:Verdana;">1.93)), left vs. right hemicolectomy (1.39 (1.03;1.87)), and perioperative</span><span style="font-family:Verdana;"> blood transfusion (1.25 (1.01;1.55)) were predictors of reduced survival. Health without known comorbidity (0.71 (0.58;0.88)), D2 versus D1 lymph node dissection (0.66 (0.53;0.83)) and tumour Stage I, II, III versus Stage IV 0.10 (0.06;0.16), 0.14 (0.11;0.19), 0.23 (0.18;0.30) were associated with prolonged survival. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> In 28.7% of the patients, the cause of death was other than colorectal cancer recurrence. Age, sex, comorbidity, emergency resec</span><span style="font-family:Verdana;">tion, lack of lymph node dissection, tumour stage, and preoperative blood</span><span style="font-family:Verdana;"> transfusions are all significant predictors for reduced survival after surgery for colon cancer.</span></span>
文摘AIM: To analyze the predictive factors for lymph node metastasis (LNM) in early gastric cancer (EGC). METHODS: Data from patients surgically treated for gastric cancers between January 1994 and December 2007 were retrospectively collected. Clinicopathological factors were analyzed to identify predictive factors for LNM. RESULTS: Of the 2936 patients who underwent gas-trectomy and lymph node dissection, 556 were diag-nosed with EGC and included in this study. Among these, 4.1% of patients had mucosal tumors (T1a) with LNM while 24.3% of patients had submucosal tumorswith LNM. Univariate analysis found that female gen-der, tumors ≥ 2 cm, tumor invasion to the submucosa, vascular and lymphatic involvement were significantly associated with a higher rate of LNM. On multivariate analysis, tumor size, lymphatic involvement, and tumor with submucosal invasion were associated with LNM. CONCLUSION: Tumor with submucosal invasion, size ≥ 2 cm, and presence of lymphatic involvement are predictive factors for LNM in EGC.
