scholarly journals The Right Study Design Is Needed to Find out which Patients Benefit from Preoperative Chemoradiotherapy for Intermediate Staged Rectal Cancer

Onkologie ◽  
2011 ◽  
Vol 34 (1-2) ◽  
pp. 6-8 ◽  
Author(s):  
Vincenzo Valentini
Keyword(s):  
Rectal Cancer ◽  
Study Design ◽  
Preoperative Chemoradiotherapy ◽  
The Right

scholarly journals The effect of preoperative chemoradiotherapy on the latency of the genital nerve and the contractility of the anal sphincter

2012 ◽  
Vol 93 (1) ◽  
pp. 52-56
Author(s):  
Yu A Shelygin ◽  
A O Rasulov ◽  
Yu A Dzhanaev ◽  
A V Boyko ◽  
I V Droshneva
Keyword(s):  
Rectal Cancer ◽  
Anal Sphincter ◽  
Surgical Intervention ◽  
External Sphincter ◽  
Preoperative Chemoradiotherapy ◽  
Postoperative Adjuvant Chemotherapy ◽  
Electrical Potentials ◽  
Preoperative Chemoradiation Therapy ◽  
Male Patients ◽  
The Right

Aim. To study the effect of chemoradiotherapy on the latency of genital nerves and contractility of the anal sphincter in patients with rectal cancer. Methods. Analyzed were 20 cases of rectal cancer T2-3NXM0 (12 males, 8 females). Complex treatment included preoperative chemoradiation therapy (total focal dose 47 Gy, fluorouracil - 2.5-3 g, cisplatin - 90 mg), surgical intervention and postoperative adjuvant chemotherapy for the period from 2009 to 2010. Before the initiation and after the chemoradiotherapy conducted was an evaluation of latency of the genital nerve and needle electromyography of the anal sphincter. Results. Due to the conduction of chemoradiotherapy the median latency of the right branch in males increased significantly from 2.9 to 4.3 ms, in females from 2.1 to 2.4 ms. The increase in the latency of the left branch of the genital nerve was observed in males (from 5.4 to 10.9 ms), while in women registered was a decrease of the indices (from 4.3 to 2.5 ms). A significant reduction of the potential of the external sphincter at rest (from 226.5±157.3 to 196.9±141 mV) and during conation (from 369.7±226.4 to 262.4±138.1 mV), regardless of gender. Conclusion. Conduction of preoperative chemoradiotherapy for cancer of the lower and middle ampullary part of the rectum leads to a decrease in the conduction speed along the genital nerve predominantly in male patients, and is accompanied by a decrease in electrical potentials of the external anal sphincter.

Oncological Impact of Lateral Lymph Node Dissection After Preoperative Chemoradiotherapy in Patients with Rectal Cancer

2020 ◽  
Vol 27 (9) ◽  
pp. 3525-3533
Author(s):  
Min Jung Kim ◽  
George J. Chang ◽  
Han-Ki Lim ◽  
Mi Kyung Song ◽  
Sung Chan Park ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Preoperative Chemoradiotherapy ◽  
Lateral Lymph Node Dissection ◽  
Node Dissection ◽  
Lateral Lymph Node

scholarly journals Difference in surgical outcomes of rectal cancer by study design: meta-analyses of randomized clinical trials, case-matched studies, and cohort studies

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
N Hoshino ◽  
T Sakamoto ◽  
K Hida ◽  
Y Takahashi ◽  
H Okada ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Robotic Surgery ◽  
Cohort Studies ◽  
Anastomotic Leakage ◽  
Study Design ◽  
Randomized Clinical Trials ◽  
Postoperative Mortality ◽  
Resection Margins ◽  
Meta Analyses

Abstract Background RCTs are considered the standard in surgical research, whereas case-matched studies and propensity score matching studies are conducted as an alternative option. Both study designs have been used to investigate the potential superiority of robotic surgery over laparoscopic surgery for rectal cancer. However, no conclusion has been reached regarding whether there are differences in findings according to study design. This study aimed to examine similarities and differences in findings relating to robotic surgery for rectal cancer by study design. Methods A comprehensive literature search was conducted using PubMed, Scopus, and Cochrane CENTRAL to identify RCTs, case-matched studies, and cohort studies that compared robotic versus laparoscopic surgery for rectal cancer. Primary outcomes were incidence of postoperative overall complications, incidence of anastomotic leakage, and postoperative mortality. Meta-analyses were performed for each study design using a random-effects model. Results Fifty-nine articles were identified and reviewed. No differences were observed in incidence of anastomotic leakage, mortality, rate of positive circumferential resection margins, conversion rate, and duration of operation by study design. With respect to the incidence of postoperative overall complications and duration of hospital stay, the superiority of robotic surgery was most evident in cohort studies (risk ratio (RR) 0.83, 95 per cent c.i. 0.74 to 0.92, P < 0.001; mean difference (MD) –1.11 (95 per cent c.i. –1.86 to –0.36) days, P = 0.004; respectively), and least evident in RCTs (RR 1.12, 0.91 to 1.38, P = 0.27; MD –0.28 (–1.44 to 0.88) days, P = 0.64; respectively). Conclusion Results of case-matched studies were often similar to those of RCTs in terms of outcomes of robotic surgery for rectal cancer. However, case-matched studies occasionally overestimated the effects of interventions compared with RCTs.

scholarly journals Is T classification still correlated with lymph node status after preoperative chemoradiotherapy for rectal cancer?

Cancer ◽  
2006 ◽  
Vol 106 (8) ◽  
pp. 1694-1700 ◽  
Author(s):  
Duck-Woo Kim ◽  
Dae Yong Kim ◽  
Tae Hyun Kim ◽  
Kyung Hae Jung ◽  
Hee Jin Chang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Preoperative Chemoradiotherapy ◽  
Lymph Node Status ◽  
Node Status ◽  
T Classification

Comparison of Bone-Conducted Vibration for Eliciting Ocular Vestibular-Evoked Myogenic Potentials

2011 ◽  
Vol 146 (2) ◽  
pp. 289-294 ◽  
Author(s):  
Chia-Chen Tseng ◽  
Shou-Jen Wang ◽  
Yi-Ho Young
Keyword(s):  
Prospective Study ◽  
Study Design ◽  
Healthy Subjects ◽  
University Hospital ◽  
Vestibular Evoked Myogenic Potentials ◽  
Ménière’S Disease ◽  
Asymmetry Ratio ◽  
Significant Difference ◽  
The Asymmetry ◽  
The Right

Objective. This study compared bone-conducted vibration (BCV) stimuli at forehead (Fz) and mastoid sites for eliciting ocular vestibular-evoked myogenic potentials (oVEMPs). Study Design. Prospective study. Setting. University hospital. Methods. Twenty healthy subjects underwent oVEMP testing via BCV stimuli at Fz and mastoid sites. Another 50 patients with unilateral Meniere’s disease also underwent oVEMP testing. Results. All healthy subjects showed clear oVEMPs via BCV stimulation regardless of the tapping sites. The right oVEMPs stimulated by tapping at the right mastoid had earlier nI and pI latencies and a larger nI-pI amplitude compared with those stimulated by tapping at the Fz and left mastoid. Similar trends were also observed in left oVEMPs. However, the asymmetry ratio did not differ significantly between the ipsilateral mastoid and Fz sites. Clinically, tapping at the Fz revealed absent oVEMPs in 28% of Meniere’s ears, which decreased to 16% when tapping at the ipsilesional (hydropic) mastoid site, exhibiting a significant difference. Conclusion. Tapping at the ipsilateral mastoid site elicits earlier oVEMP latencies and larger oVEMP amplitudes when compared with tapping at the Fz site. Thus, tapping at the Fz site is suggested to screen for the otolithic function, whereas tapping at the ipsilesional mastoid site is suitable for evaluating residual otolithic function.

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