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Pedrazzani C, Turri G, Marrelli D, Kim HJ, Park EJ, Spolverato G, Foppa C, Spinelli A, Pucciarelli S, Baik SH, Choi GS. Prediction of Metachronous Peritoneal Metastases After Radical Surgery for Colon Cancer: A Scoring System Obtained from an International Multicenter Cohort. Ann Surg Oncol 2022; 29:7896-7906. [PMID: 35789302 PMCID: PMC9550705 DOI: 10.1245/s10434-022-12097-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/12/2022] [Indexed: 01/01/2023]
Abstract
Background Since novel strategies for prevention and treatment of metachronous peritoneal metastases (mPM) are under study, it appears crucial to identify their risk factors. Our aim is to establish the incidence of mPM after surgery for colon cancer (CC) and to build a statistical model to predict the risk of recurrence. Patients and Methods Retrospective analysis of consecutive pT3–4 CC operated at five referral centers (2014–2018). Patients who developed mPM were compared with patients who were PM-free at follow-up. A scoring system was built on the basis of a logistic regression model. Results Of the 1423 included patients, 74 (5.2%) developed mPM. Patients in the PM group presented higher preoperative carcinoembryonic antigen (CEA) [median (IQR): 4.5 (2.5–13.0) vs. 2.7 (1.5–5.9), P = 0.001] and CA 19-9 [median (IQR): 17.7 (12.0–37.0) vs. 10.8 (5.0–21.0), P = 0.001], advanced disease (pT4a 42.6% vs. 13.5%; pT4b 16.2% vs. 3.2%; P < 0.001), and negative pathological characteristics. Multivariate logistic regression identified CA 19-9, pT stage, pN stage, extent of lymphadenectomy, and lymphovascular invasion as significant predictors, and individual risk scores were calculated for each patient. The risk of recurrence increased remarkably with score values, and the model demonstrated a high negative predictive value (98.8%) and accuracy (83.9%) for scores below five. Conclusions Besides confirming incidence and risk factors for mPM, our study developed a useful clinical tool for prediction of mPM risk. After external validation, this scoring system may guide personalized decision-making for patients with locally advanced CC. Supplementary Information The online version contains supplementary material available at 10.1245/s10434-022-12097-9.
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Affiliation(s)
- Corrado Pedrazzani
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Verona University Hospital, University of Verona, Verona, Italy.
| | - Giulia Turri
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Verona University Hospital, University of Verona, Verona, Italy
| | - Daniele Marrelli
- Department of Surgery, Policlinico le Scotte, University of Siena, Siena, Italy
| | - Hye Jin Kim
- Colorectal Cancer Centre, Kyungpook National University Medical Centre, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Eun Jung Park
- Division of Colon and Rectal Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gaya Spolverato
- General Surgery 3, Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Caterina Foppa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Salvatore Pucciarelli
- General Surgery 3, Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Seung Hyuk Baik
- Division of Colon and Rectal Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gyu Seog Choi
- Colorectal Cancer Centre, Kyungpook National University Medical Centre, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Zhong M, He L, Chen M, Lu Z, Li R, Li L. Effect Evaluation of Comfort Nursing Materials Assisted Nursing for Patients with Advanced Malignant Tumor. SCANNING 2022; 2022:4766252. [PMID: 35822164 PMCID: PMC9232297 DOI: 10.1155/2022/4766252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 05/28/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
In order to explore the effect of comfort care on patients with advanced malignant tumors assisted by bioceramics, 82 patients with advanced malignant tumors admitted to a cancer hospital were selected as the research object control group: 26 males and 15 females and the observation group: 25 males and 16 females. The control group was given routine care, and the observation group was given comfort care on the basis of the control group. The quality of life (QLQ-C30 functional scale) and nursing satisfaction before and after nursing were compared between the two groups. The results of the study indicate that after care, the physical, role, emotional, cognitive, social, general health, and symptom scores of the observation group were significantly higher than those of the control group, the nursing satisfaction degree of the observation group was 97.56%, which was significantly higher than that of the control group of 82.93%, and the difference was statistically significant (P < 0.05). Comfortable care has a definite effect on the care of patients with advanced malignant tumors; it can improve the overall comfort and satisfaction of patients, effectively reduce adverse events, and improve the quality of life of patients.
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Affiliation(s)
- Mei Zhong
- Department of Intensive Care Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Lanying He
- Department of Intensive Care Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Min Chen
- Department of Intensive Care Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Zhongxiang Lu
- Department of Intensive Care Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Ruyu Li
- Department of Intensive Care Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Ling Li
- Department of Intensive Care Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
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Larentzakis A, Anagnostou E, Georgiou K, Vrakopoulou GZ, Zografos CG, Zografos GC, Toutouzas KG. Place of hyperthermic intraperitoneal chemotherapy in the armament against pancreatic adenocarcinoma: A survival, mortality and morbidity systematic review. Oncol Lett 2021; 21:246. [PMID: 33664810 PMCID: PMC7882886 DOI: 10.3892/ol.2021.12507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 01/25/2021] [Indexed: 12/20/2022] Open
Abstract
Pancreatic adenocarcinoma is one of the deadliest types of cancer worldwide, with a 5-year survival rate of 8% despite recent treatment advancements. The present systematic review aimed to investigate the role of hyperthermic intraperitoneal chemotherapy (HIPEC) following surgical resection for pancreatic adenocarcinoma, with or without peritoneal carcinomatosis. A systematic search of the MEDLINE and SCOPUS electronic databases was performed according to PRISMA guidelines. All possible relevant articles published between January 1980 and May 2019 were retrieved using multiple search terms associated with HIPEC and pancreatic adenocarcinoma. The initial search resulted in 1,244 reports, which condensed to 41 reports following screening of titles and abstracts, and subsequently to four reports following full-text thorough examination. The four reports included involved a prospective cohort study of HIPEC use in resectable pancreatic adenocarcinoma, and three retrospective studies of HIPEC use following cytoreductive surgery for peritoneal carcinomatosis due to pancreatic adenocarcinoma, resulting in a total of 47 patients. The overall survival ranged between 2 and 62 months, and the hospital mortality rate was 8.5%. Morbidity (34%) was mainly attributed to anastomotic leak or respiratory failure. Due to the small sample size and low quality of evidence of the included studies, no valid conclusions could be drawn. Therefore, further studies are required to justify the use of HIPEC as an adjuvant therapy in resectable pancreatic adenocarcinoma, while cytoreductive surgery and HIPEC in peritoneal carcinomatosis of pancreatic origin seems not only not useful but also unsafe at this level of evidence.
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Affiliation(s)
- Andreas Larentzakis
- First Department of Propaedeutic Surgery, Athens Medical School, National and Kapodistrian University of Athens, Hippocration General Athens Hospital, Athens 11527, Greece
| | - Evangelos Anagnostou
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Whitechapel, E1 2AT London, UK
| | - Konstantinos Georgiou
- First Department of Propaedeutic Surgery, Athens Medical School, National and Kapodistrian University of Athens, Hippocration General Athens Hospital, Athens 11527, Greece
| | - Gavriella-Zoi Vrakopoulou
- First Department of Propaedeutic Surgery, Athens Medical School, National and Kapodistrian University of Athens, Hippocration General Athens Hospital, Athens 11527, Greece
| | - Constantinos G Zografos
- First Department of Surgery, Athens Medical School, National and Kapodistrian University of Athens, Laikon General Hospital, Goudi, Athens 11527, Greece
| | - Georgios C Zografos
- First Department of Propaedeutic Surgery, Athens Medical School, National and Kapodistrian University of Athens, Hippocration General Athens Hospital, Athens 11527, Greece
| | - Konstantinos G Toutouzas
- First Department of Propaedeutic Surgery, Athens Medical School, National and Kapodistrian University of Athens, Hippocration General Athens Hospital, Athens 11527, Greece
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