Combined mechanical and oral antibiotic bowel preparation is associated with prolonged recurrence‐free survival following surgery for colorectal cancer

Author(s):  
Lindsey M. Zhang ◽  
Darryl Schuitevoerder ◽  
Michael G. White ◽  
Susan Feldt ◽  
Pranav Krishnan ◽  
...  
2018 ◽  
Vol 55 (3) ◽  
pp. 258-263 ◽  
Author(s):  
Claudemiro QUIREZE JUNIOR ◽  
Andressa Machado Santana BRASIL ◽  
Lúcio Kenny MORAIS ◽  
Edmond Raymond Le CAMPION ◽  
Eliseu José Fleury TAVEIRA ◽  
...  

ABSTRACT BACKGROUND: Liver metastases from colorectal cancer are an important public health problem due to the increasing incidence of colorectal cancer worldwide. Synchronous colorectal liver metastasis has been associated with worse survival, but this prognosis is controversial. OBJECTIVE: The objective of this study was to evaluate the recurrence-free survival and overall survival between groups of patients with metachronous and synchronous colorectal hepatic metastasis. METHODS: This was a retrospective analysis of medical records of patients with colorectal liver metastases seen from 2013 to 2016, divided into a metachronous and a synchronous group. The Cox regression model and the Kaplan-Meier method with log-rank test were used to compare survival between groups. RESULTS: The mean recurrence-free survival was 9.75 months and 50% at 1 year in the metachronous group and 19.73 months and 63.3% at 1 year in the synchronous group. The mean overall survival was 20.00 months and 6.2% at 3 years in the metachronous group and 30.39 months and 31.6% at 3 years in the synchronous group. Patients with metachronous hepatic metastasis presented worse overall survival in multivariate analysis. The use of biological drugs combined with chemotherapy was related to the best overall survival prognosis. CONCLUSION: Metachronous colorectal hepatic metastasis was associated with a worse prognosis for overall survival. There was no difference in recurrence-free survival between metachronous and synchronous metastases.


2017 ◽  
Vol 11 (11) ◽  
pp. 1544-1560 ◽  
Author(s):  
Xianglong Tian ◽  
Xiaoqiang Zhu ◽  
Tingting Yan ◽  
Chenyang Yu ◽  
Chaoqin Shen ◽  
...  

2019 ◽  
Vol 91 (3) ◽  
pp. 10-14 ◽  
Author(s):  
Zbigniew Małek ◽  
Piotr Małek ◽  
Łukasz Dziki

Introduction Colorectal cancer is the most common gastrointestinal cancer treated by departments and surgical clinics in Poland. Currently, the biggest challenge of surgery is to reduce the number of leaks in the bowel anastomoses and postoperative wound infections to a minimum. Objective Whether bowel preparation before surgery affects the early results of treatment? Methods The study was retrospective and included patients operated electively on one surgical center due to colorectal and rectal cancer in years 2013-2018. Patients who underwent surgery were divided into two groups in the study. The first was 109 patients with mechanical bowel irrigation. The second group of 118 patients, in addition to mechanical bowel preparation, received an oral antibiotic. Results The studied groups did not differ significantly in terms of traits that could affect the results of treatment within 30 days of surgery. Postoperative mortality was 0,9% and 0,85%. Complications: leakage of the bowel anastomosis 1,8% and 1,7%, postoperative obstruction 3,7% and 5,0%, wound dehiscence 2,75% and 0,85%, infection of the surgical site 13,8% and 3,4% respectively in the first and second group of patients. Conclusion 1. Mechanical bowel preparation in combination with the oral supply of antibiotic significantly reduces the frequency of surgical site infection compared to the mechanical rinsing itself. 2. Type of preparation of the intestine before the surgery does not significantly affect postoperative mortality and other complications, including anastomotic leak, but may be important for the frequency of postoperative wound dehiscence.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 20114-20114
Author(s):  
T. Kanazawa ◽  
T. Watanabe ◽  
H. Nagawa

20114 Background: Identification of patients at high risk for recurrence remains a central issue in the treatment of colorectal cancer. Our goal was to identify predictive factors for recurrence in colorectal cancer patients. Methods: DNA from 84 colorectal cancers were analyzed for wide-ranging allelotyping. Using 27 microsatellite markers spanning every 10cM on chromosome 17 and 18, we defined the LOH-ratio as the proportion of markers which show LOH out of 27 markers. Tumors were grouped into two groups by the median value of LOH-ratio (0.19). Recurrence free survival was compared with Kaplan-Meier analysis and log rank statistic. The Cox proportional hazards regression model was used for both univariate and multivariate analysis of recurrence free survival. Results: Log rank statistic revealed that LOH-ratio, stage, lymph node metastasis significantly related to recurrence free survival. On univariate analysis, significant predictors of Recurrence free survival were LOH-ratio, lymph node metastasis, Dukes’ classification, and pathological type. On multivariate analysis, LOH-ratio (HR 3.1, p = 0.02) and lymph node metastasis (HR 5.2, p = 0.002) independently predicted for recurrence free survival. Conclusions: LOH-ratio and lymph node metastasis were the only independent predictors of recurrence free survival. Altogether with lymph node metastasis, LOH-ratio could help to improve postoperative surveillance and adjuvant therapy. No significant financial relationships to disclose.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14114-e14114
Author(s):  
Justin Y Jeon ◽  
Deok Hyun Jeong ◽  
Min Keun Park ◽  
Jennifer A. Ligibel ◽  
Jeffrey A. Meyerhardt ◽  
...  

e14114 Background: Background: Conflicting results have been reported whether pre diagnosis diabetes mellitus (DM) influence survival of colorectal cancer patients or not. Therefore, we determine the influence of DM on long-term outcomes of stage 1-3 patients with resected colon and rectal cancer. Methods: This prospective study include a total of 4,131 participants who were treated for cancer between 1995 and 2005 in South Korea in a single hospital (Non DM: 3,614 patients, DM: 517 patients) with average follow up period of 12 years. We analyzed differences in all cause mortality, disease free survival (DFS), recurrence free survival (RFS) and colorectal cancer-specific mortality between colorectal patients with DM and those without DM. Results: After adjustment for potential confounders, pre-diagnosis DM significantly associated with increased all cause mortality (HR: 1.46, 95% CI: 1.11-1.92), and recurrence free survival reduced DFS (HR: 1.45, 95%CI: 1.15-1.84) and RFS (HR: 1.32, 95% CI: 0.98-1.76) in colon cancer patients but not in rectal cancer patients. In colon cancer patients, DM negatively affects the survival outcome of proximal colon cancer (HR: 2.08, 95%CI: 1.38-3.13), but not of distal cancer (HR:1.34, 95% CI: 0.92-1.96). Conclusions: To our knowledge, the current study first reported the effects of pre-diagnosis DM on survival outcome of colorectal cancer are site specific (proximal colon, distal colon and rectum). The current study was supported by the National Research Foundation of Korea (KRF) (No. 2011-0004892) and the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1120230). [Table: see text]


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