Predictors of long-term survival in patients with hepatic resection of colorectal metastases: Analysis of a Brazilian Cancer Center Cohort

BACKGROUND

Hepatic metastases are a major cause of death in patients with colorectal cancer. A comprehensive assessment of the prognostic factors associated with long-term survival could improve patient selection for surgical approaches and decrease morbidity and futile locoregional treatments.

METHODS

We performed a retrospective analysis of patients who underwent hepatectomy for colorectal liver metastases at a single center from 2000 to 2012.

RESULTS

To identify factors associated with 5- and 10-year overall (OS) and disease-free survival (DFS), we analyzed 280 patients and 150 patients in the 5- and 10-year cohorts, respectively. Only seven relapses occurred after 5 years of follow-up, and no relapses occurred after 10 years. Multivariable analysis indicated that bilobar disease and extra-hepatic disease before hepatectomy were independent 5- and 10-year predictors of OS, and major postoperative complications predicted OS in the 5-year survival cohort only. Our analysis indicated that prognostic factors associated with DFS included some confounders and was therefore inconclusive.

CONCLUSIONS

Taken together, our results suggest that the predictors of 5- and 10-year OS rates of colorectal cancer patients with hepatic metastases are similar, differing only by postoperative complications that influenced exclusively 5-year survival. Since no relapse occurred 10 years after hepatic resection, oncological remission is likely.

Is primary sidedness a prognostic factor in patients with resected colon cancer liver metastases (CLM)?

BACKGROUND AND OBJECTIVES

Recent studies have suggested that sidedness of origin from colorectal adenocarcinomas is a predictor of survival, however the impact of this factor in patients with resected colon cancer liver metastases (CLM) is not clear. So, in this study, we compared clinic and pathologic characteristics and long-term survival of patients with resected CLM according to the primary tumor location.

METHODS

This is a retrospective analyzes of a prospective database. Patients with resected CLM from 1998 to 2012 were included. Right colon included tumors from cecum to middle transverse colon, and left colon included tumors from splenic flexure to sigmoid.

RESULTS

One hundred fifty-one patients were included, 27 right colon and 124 left colon. In the latter group, there were more patients with synchronous disease (67.7 × 6.2%, P = 0.026) and a higher CEA (22.0 × 11.7 ng/mL, P = 0.001). However, K-Ras mutation was more frequent in right sided tumors (75.0 × 24.1%, P = 0.001). There was no difference in long term survival in both groups in this series even when adjusted for the confounding variables.

CONCLUSION

Sidedness do not seem to be a predictor of long term survival in patients with resected colon cancer liver metastases.

Retentores Intraradiculares Estéticos Fabricados por CAD/CAM: Resistência à Fratura e à União Após Fadiga

Os objetivos do estudo foram avaliar a resistência à fratura (RF) após fadiga e a resistência de união ao push-out (RU) com e sem fadiga, em retentores intrarradiculares personalizados fabricados com diferentes materiais estéticos em CAD/CAM. Noventa dentes foram selecionados, preparados endodonticamente e submetidos ao preparo do espaço intraradicular. Os dentes foram distribuídos aleatoriamente em 3 grupos de acordo com o material do retentor: fibra de vidro experimental (FV) cerâmica híbrida Vita Enamic (CH) e resina composta nano cerâmica Lava Ultimate (RC). Os restentores foram fabricados em CAD/CAM e cimentados com cimento resinoso autoadesivo (Rely X U200). Um subgrupo de 30 espécimes (n10) foi submetido a fadiga (1.000.000 ciclos a       5 Hz) e, em seguida, ao ensaio de RF. Outro subgrupo com 60 espécimes foi submetido ao ensaio de RU, com e sem fadiga. Os dados foram submetidos à análise de variância (RF - ANOVA 1 fator RU - ANOVA 2 fatores) e teste de Tukey (a0,05). As médias de RF (N±DP) para os materiais foram 407,61±109,04 (FV), 414.52±83.95 (CH), and 621,38±100,35 (RC), com RC apresentando valores de RF significativamente superiores (p<0,05). Para RU, não houve diferença estatisticamente significante entre os materiais, com e sem fadiga (p>0,05). Pode-se concluir que o tipo de material utilizado para confecção do retentor personalizado influenciou significativamente na RF, mas não na RU dos espécimes. A realização da fadiga não influenciou na RU para os diferentes materiais.Palavras-chave: CAD-CAM. Pino Intrarradicular. Materiais Dentários.