A Comparative Study on the Short-Term Clinical Outcomes of Laparoscopic Versus Open Hartmann's Procedure for High Risk Patients in Colorectal Cancer

2011 ◽  
Author(s):  
Jo Tashiro ◽  
Shigeki Yamaguchi ◽  
Toshimasa Ishii ◽  
Takahiro Sato ◽  
Hirokazu Suwa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Comparative Study ◽  
Clinical Outcomes ◽  
Hartmann’S Procedure ◽  
Short Term ◽  
High Risk Patients ◽  
Hartmann's Procedure ◽  
Risk Patients

636 SHORT-TERM OUTCOME FOR HIGH-RISK PATIENTS AFTER ESOPHAGECTOMY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Victor Plat ◽  
Wessel Stam ◽  
Boukje Bootsma ◽  
Jennifer Straatman ◽  
Thomas Klausch ◽  
...  
Keyword(s):  
High Risk ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Charlson Comorbidity Index ◽  
Short Term ◽  
Term Outcome ◽  
High Risk Patients ◽  
Short Term Outcome ◽  
Risk Patients ◽  
Comorbidity Index

Abstract   Transthoracic esophagectomy (TTE) for esophageal cancer facilitates mediastinal dissection, however it has a significant impact on cardiopulmonary status. High-risk patients may therefore be better candidates for transhiatal esophagectomy (THE) in order to prevent serious complications. This study addressed short-term outcome following TTE and THE in patients that are considered to have a higher risk of surgery-related morbidity. Methods This population-based study included patients who underwent a curative esophagectomy between 2011 and 2018, registered in the Dutch Upper GI Cancer Audit. The Charlson comorbidity index was used to assign patients to a low-risk (score ≤ 1) and high-risk group (score ≥ 2). Propensity score matching was applied to produce comparable groups between high-risk patients receiving TTE and THE. Primary endpoint was mortality (in-hospital/30-day mortality), secondary endpoints included morbidity and oncological outcomes. Additionally, a matched subgroup analysis was performed, including only cervical reconstructions. Results Of 5438 patients, 945 and 431 high-risk patients underwent TTE and THE respectively. After propensity score matching, mortality (6.3% vs 3.3%, P = 0.050), overall morbidity, Clavien-Dindo ≥3 complications, pulmonary complications, cardiac complications and re-interventions were significantly more observed after TTE compared to THE. A significantly higher mortality after TTE with a cervical reconstruction was found compared to THE (7.0% vs 2.2%, P = 0.020). Conclusion Patients with a high Charlson comorbidity index predispose for a complicated postoperative course after esophagectomy, this was more outspoken after TTE compared to THE. In daily practice these outcomes should be balanced with the lower lymph node yield, but comparable positive node count and radicality after THE.

Prognostic implications of pre-ablation stimulated Tg: a retrospective analysis of 2500 thyroid cancer patients

2021 ◽  
Author(s):  
Tian Tian ◽  
Yangmengyuan Xu ◽  
Xinyue Zhang ◽  
Bin Liu
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Risk Stratification ◽  
Clinical Outcomes ◽  
Recurrent Disease ◽  
Clinicopathological Parameters ◽  
Characteristic Analysis ◽  
High Risk Patients ◽  
Risk Patients ◽  
Risk Categories

Abstract Context The risk of persistent and recurrent disease in patients with differentiated thyroid cancer (DTC) is a continuum that ranges from very low to very high, even within the three primary risk categories. It is important to identify independent clinicopathological parameters to accurately predict clinical outcomes. Objective To examine the association between pre-ablation stimulated thyroglobulin (ps-Tg) and persistent and recurrent disease in DTC patients and investigate whether incorporation of ps-Tg could provide a more individualized estimate of clinical outcomes. Design, Setting, and Participants Medical records of 2524 DTC patients who underwent total thyroidectomy and radioiodine ablation between 2006 and 2018 were retrospectively reviewed. Main Outcome Measure Ps-Tg was measured under thyroid hormone withdrawal before remnant ablation. Association of ps-Tg and clinical outcomes. Results In multivariate analysis, age, ATA risk stratification, M1, ps-Tg and cumulative administered activities were the independent predictive factors for persistent/ recurrent disease. Receiver operating characteristic analysis identified ps-Tg cutoff (≤ 10.1 ng/mL) to predict disease free status with a negative predictive value of 95%, and validated for all ATA categories. Integration of ps-Tg into ATA risk categories indicated that the presence of ps-Tg ≤ 10.1 ng/mL was associated with a significantly decreased chance of having persistent/recurrent disease in intermediate- and high-risk patients (9.9 to 4.1% in intermediate-risk patients, and 33.1 to 8.5% in high-risk patients). Conclusion Ps-Tg (≤ 10.1 ng/mL) was a key predictor of clinical outcomes in DTC patients. Its incorporation as a variable in the ATA risk stratification system could more accurately predict clinical outcomes.

scholarly journals A STING-related prognostic score predicts high-risk patients of colorectal cancer and provides insights into immunotherapy

2021 ◽  
Vol 9 (1) ◽  
pp. 14-14
Author(s):  
Si-Yuan Chen ◽  
Siyu Chen ◽  
Wanjing Feng ◽  
Ziteng Li ◽  
Yixiao Luo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Prognostic Score ◽  
High Risk Patients ◽  
Risk Patients

Dementia screening in elderly high-risk patients following heart failure decompensation may predict unfavorable long-term clinical outcomes

2021 ◽  
Vol 69 (3) ◽  
Author(s):  
Konrad STEPIEN ◽  
Patrycja FURCZYNSKA ◽  
Magdalena ZALEWSKA ◽  
Karol NOWAK ◽  
Aleksandra WLODARCZYK ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Clinical Outcomes ◽  
High Risk Patients ◽  
Dementia Screening ◽  
Risk Patients ◽  
Heart Failure Decompensation

Su2061 CLINICAL OUTCOMES OF HIGH-RISK PATIENTS TREATED OF PERCUTANEOUS CHOLECYSTOSTOMY TUBE DRAINAGE

2020 ◽  
Vol 158 (6) ◽  
pp. S-1567
Author(s):  
Krishnamurthy B. Vaishnavi ◽  
Christopher P. Rice ◽  
Celia Chao ◽  
Farhan Ahmad ◽  
William J. Mileski
Keyword(s):  
High Risk ◽  
Clinical Outcomes ◽  
Percutaneous Cholecystostomy ◽  
Tube Drainage ◽  
High Risk Patients ◽  
Risk Patients ◽  
Cholecystostomy Tube ◽  
Percutaneous Cholecystostomy Tube

scholarly journals Stage IV Colorectal Cancer Patients with High Risk Mutation Profiles Survived 16 Months Longer with Individualized Therapies

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 393
Author(s):  
Alexander Hendricks ◽  
Anu Amallraja ◽  
Tobias Meißner ◽  
Peter Forster ◽  
Philip Rosenstiel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Practice ◽  
High Risk ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Standard Of Care ◽  
High Risk Patients ◽  
Risk Patients ◽  
Individualized Treatments ◽  
Colorectal Cancer Patients

Personalized treatment vs. standard of care is much debated, especially in clinical practice. Here we investigated whether overall survival differences in metastatic colorectal cancer patients are explained by tumor mutation profiles or by treatment differences in real clinical practice. Our retrospective study of metastatic colorectal cancer patients of confirmed European ancestry comprised 54 Americans and 54 gender-matched Germans. The Americans received standard of care, and on treatment failure, 35 patients received individualized treatments. The German patients received standard of care only. Tumor mutations, tumor mutation burden and microsatellite status were identified by using the FoundationOne assay or the IDT Pan-Cancer assay. High-risk patients were identified according to the mutational classification by Schell and colleagues. Results: Kaplan–Meier estimates show the high-risk patients to survive 16 months longer under individualized treatments than those under only standard of care, in the median (p < 0.001). Tumor mutation profiles stratify patients by risk groups but not by country. Conclusions: High-risk patients appear to survive significantly longer (p < 0.001) if they receive individualized treatments after the exhaustion of standard of care treatments. Secondly, the tumor mutation landscape in Americans and Germans is congruent and thus warrants the transatlantic exchange of successful treatment protocols and the harmonization of guidelines.

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