scholarly journals Complete state-wide outcomes in elective colon cancer surgery

2018 ◽  
Vol 88 (11) ◽  
pp. 1174-1177 ◽  
Author(s):  
Ian G. Faragher ◽  
Michael K.-Y. Hong ◽  
Douglas Stupart ◽  
David A. Watters ◽  
Justin Yeung
2019 ◽  
Vol 31 ◽  
pp. 108
Author(s):  
R. Ahl ◽  
P. Matthiessen ◽  
G. Sjolin ◽  
Y. Cao ◽  
O. Ljungqvist ◽  
...  

2018 ◽  
Vol 25 ◽  
pp. 196-197
Author(s):  
Rebecka Ahl ◽  
Peter Matthiessen ◽  
Xin Fang ◽  
Yang Cao ◽  
Göran Wallin ◽  
...  

2020 ◽  
Vol 22 (11) ◽  
pp. 1585-1596
Author(s):  
S. Niemeläinen ◽  
H. Huhtala ◽  
A. Ehrlich ◽  
J. Kössi ◽  
E. Jämsen ◽  
...  

2019 ◽  
Vol 35 (2) ◽  
pp. 307-315 ◽  
Author(s):  
Susanna Niemeläinen ◽  
Heini Huhtala ◽  
Anu Ehrlich ◽  
Jyrki Kössi ◽  
Esa Jämsen ◽  
...  

Abstract Purpose Patients aged > 80 years represent an increasing proportion of colon cancer diagnoses. Selecting patients for elective surgery is challenging because of possibly compromised health status and functional decline. The aim of this retrospective, population-based study was to identify risk factors and health measures that predict short-term mortality after elective colon cancer surgery in the aged. Methods All patients > 80 years operated electively for stages I–III colon cancer from 2005 to 2016 in four Finnish hospitals were included. The prospectively collected data included comorbidities, functional status, postoperative surgical and medical outcomes as well as mortality data. Results A total of 386 patients (mean 84.0 years, range 80–96, 56% female) were included. Male gender (46% vs 35%, p = 0.03), higher BMI (51% vs 37%, p = 0.02), diabetes mellitus (51% vs 37%, p = 0.02), coronary artery disease (52% vs 36%, p = 0.003) and rheumatic diseases (67% vs 39%, p = 0.03) were related to higher risk of complications. The severe complications were more common in patients with increased preoperative hospitalizations (31% vs 15%, p = 0.05) and who lived in nursing homes (30% vs 17%, p = 0.05). The 30-day and 1-year mortality rates were 6.0% and 15% for all the patients compared with 30% and 45% in patients with severe postoperative complications (p < 0.001). Severe postoperative complications were the only significant patient-related variable affecting 1-year mortality (OR 9.60, 95% CI 2.33–39.55, p = 0.002). Conclusions The ability to identify preoperatively patients at high risk of decreased survival and thus prevent severe postoperative complications could improve overall outcome of aged colon cancer patients.


BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036164 ◽  
Author(s):  
Rebecka Ahl ◽  
Peter Matthiessen ◽  
Gabriel Sjölin ◽  
Yang Cao ◽  
Göran Wallin ◽  
...  

ObjectiveColon cancer surgery remains associated with substantial postoperative morbidity and mortality despite advances in surgical techniques and care. The trauma of surgery triggers adrenergic hyperactivation which drives adverse stress responses. We hypothesised that outcome benefits are gained by reducing the effects of hyperadrenergic activity with beta-blocker therapy in patients undergoing colon cancer surgery. This study aims to test this hypothesis.DesignRetrospective cohort study.Setting and participantsThis is a nationwide study which includes all adult patients undergoing elective colon cancer surgery in Sweden over 10 years. Patient data were collected from the Swedish Colorectal Cancer Registry. The national drugs registry was used to obtain information about beta-blocker use. Patients were subdivided into exposed and unexposed groups. The association between beta-blockade, short-term and long-term mortality was evaluated using Poisson regression, Kaplan-Meier curves and Cox regression.Primary and secondary outcomesPrimary outcome of interest was 1-year all-cause mortality. Secondary outcomes included 90-day all-cause and 5-year cancer-specific mortality.ResultsThe study included 22 337 patients of whom 36.1% were prescribed preoperative beta-blockers. Survival was higher in patients on beta-blockers up to 1 year after surgery despite this group being significantly older and of higher comorbidity. Regression analysis demonstrated significant reductions in 90-day deaths (IRR 0.29, 95% CI 0.24 to 0.35, p<0.001) and a 43% risk reduction in 1-year all-cause mortality (adjusted HR 0.57, 95% CI 0.52 to 0.63, p<0.001) in beta-blocked patients. In addition, cancer-specific mortality up to 5 years after surgery was reduced in beta-blocked patients (adjusted HR 0.80, 95% CI 0.73 to 0.88, p<0.001).ConclusionPreoperative beta-blockade is associated with significant reductions in postoperative short-term and long-term mortality following elective colon cancer surgery. Its potential prophylactic effect warrants further interventional studies to determine whether beta-blockade can be used as a way of improving outcomes for this patient group.


Surgery ◽  
2011 ◽  
Vol 149 (2) ◽  
pp. 171-178 ◽  
Author(s):  
Toshiyuki Suzuki ◽  
Sotaro Sadahiro ◽  
Yuji Maeda ◽  
Akira Tanaka ◽  
Kazutake Okada ◽  
...  

2012 ◽  
Vol 35 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Keiichiro Ishibashi ◽  
Kensuke Kumamoto ◽  
Kouki Kuwabara ◽  
Naoko Hokama ◽  
Toru Ishiguro ◽  
...  

2014 ◽  
Vol 29 (9) ◽  
pp. 1143-1150 ◽  
Author(s):  
Raymond Oliphant ◽  
◽  
Gary A. Nicholson ◽  
Paul G. Horgan ◽  
Donald C. McMillan ◽  
...  

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