Int J Surg Oncol [JOURNAL]
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200 papers
Factors Associated With the Presence and Severity of Nutritional Impact Symptoms in Individuals With Head and Neck Cancer Before Treatment.
do Rosario TC, Soares FLP, Soares LVO … +13 more , Gallavotti JSN, Rodrigues IS, do Prado CB, de Podestá OPG, Viana KCG, Rocha RM, Lenzi J, de Podestá JRV, de Souza ED, Haraguchi FK, Petarli GB, Leopoldo AS, Salaroli LB
Int J Surg Oncol · 2024 · PMID 39758358 · Full text
As head and neck cancer (HNC) affects regions directly related to the digestive tract, it is consistently associated with nutritional impact symptoms (NISs), which further reduce food intake and affect nutritional status...
As head and neck cancer (HNC) affects regions directly related to the digestive tract, it is consistently associated with nutritional impact symptoms (NISs), which further reduce food intake and affect nutritional status. Early identification of patients with NIS can assist therapy. This is a cross-sectional study with HNC patients from a cancer reference hospital. Sociodemographic, lifestyle, clinical, and anthropometric data were collected, along with information on nutritional risk screening and screening for NIS. Cancer in the larynx (=0.031) showed a 6.67 lower NIS score than that in the oral cavity. Ex-smokers (=0.019) showed a 5.87 lower NIS score and nutritional risk (=0.009) increased NIS scores by 6.15 points. Tumor location, smoking, and the presence of nutritional risk influence the quantity and severity of NIS.
Self-Expandable Metal Stent for Palliation of Dysphagia in Cancer Esophagus at a Tertiary Care Center of North-East India: A Prospective Study.
Kundalia R, Kodali RK, Deka D … +5 more , Talukdar A, Jyoti Kalita D, Das G, Sharma S, Malhotra M
Int J Surg Oncol · 2024 · PMID 39741658 · Full text
Esophageal cancer is the sixth most common cancer in India with a incidence of around 4.5%. Dysphagia is the primary manifestation of advanced esophageal cancer in 80%-90% of patients. Dysphagia is one of the most distre...
Esophageal cancer is the sixth most common cancer in India with a incidence of around 4.5%. Dysphagia is the primary manifestation of advanced esophageal cancer in 80%-90% of patients. Dysphagia is one of the most distressing and debilitating symptom for the patients. The use of self-expanding metallic stents (SEMS) has revolutionized the treatment of dysphagia in esophageal cancer patients. This study aims to assess the role of SEMS in the palliation of dysphagia in patients with esophageal cancer. This was a single-center, prospective observational study conducted in the Department of Surgical Oncology at Dr. B. Borooah Cancer Institute in Guwahati, India, from April 2019 to March 2020. Patients were assessed after stent placement for improvements in dysphagia, pain relief, nutritional status, and associated complications. One week after stent placement, 65.3% of patients were able to tolerate semisolid food and 6.1% could tolerate solids. Prior to stent insertion, 87.8% had Grade 4 dysphagia, but at 6 months post-SEMS placement, 90.2% had only Grade 1 dysphagia. This represented a statistically significant improvement in the dysphagia grade, with a p value less than 0.0001. Further analysis using ANOVA and paired t-tests showed significant improvements in weight, body mass index (BMI), and serum albumin at 1, 3, and 6 months after stent placement, with p values less than 0.001. The results of this study demonstrated that the placement of SEMS is a safe and effective palliative intervention for management of dysphagia in carcinoma esophagus, leading to improvements in patient nutrition and quality of life, with relatively few associated complications.
A Retrospective 8-Year Single Institutional Study in Germany Regarding Diagnosis, Treatment, and Outcome of Malignant Parotid Tumors.
Andrianopoulou S, Fiedler LS, Lippert BM … +1 more , Bulut OC
Int J Surg Oncol · 2024 · PMID 39687544 · Full text
This study sought to comprehensively evaluate the diagnosis, therapeutic interventions, and outcomes of individuals afflicted with malignant parotid tumors at a tertiary care otolaryngology department in Heilbronn, Germa...
This study sought to comprehensively evaluate the diagnosis, therapeutic interventions, and outcomes of individuals afflicted with malignant parotid tumors at a tertiary care otolaryngology department in Heilbronn, Germany, spanning the years 2010-2018. The primary objective was to juxtapose this dataset with findings from analogous single and multicenter investigations. We conducted a meticulous analysis of electronic medical records pertaining to 45 patients subjected to primary parotid cancer treatment. The male-to-female ratio was 3:2, with an average age of 61 years. Predominant histological types included mucoepidermoid and squamous cell carcinomas, with ultrasound emerging as the predominant diagnostic modality (97.8% sensitivity). Intraoperative frozen sections exhibited a high level of sensitivity. Notably, lymph node metastasis was prevalent in T3 tumors, frequently located intraparotid and at Neck level II. Solely one patient exhibited distant metastases (pulmonary). All patients underwent parotidectomy, and 29% necessitated a secondary procedure due to positive resection margins. Postoperative complications encompassed facial nerve palsy, seromas, and salivary fistulas. Adjuvant radiotherapy (38%) was recommended for high-grade tumors, T3/T4 stage, N+, perineural invasion (PNI), and positive or uncertain surgical margins. Neck dissection was executed in 67% of instances, with 20% revealing occult lymph node metastases. Recurrence manifested in 22% of patients, primarily as locoregional recurrence (80%) and distant metastases (20%). The 3-year recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) rates stood at 72.1%, 91.9%, and 87.5%, respectively. Noteworthy factors influencing RFS included preoperative facial palsy, T stage, resection margins, and PNI. In summary, the management of parotid cancer involving surgical interventions, neck dissection, and radiotherapy in high-risk patients yielded commendable outcomes with minimal complications, showcasing survival rates exceeding 70%. Timely diagnosis at an early stage is imperative for achieving tumor-free margins and enhancing survival rates. More assertive therapeutic strategies are advocated for cases presenting with preoperative facial nerve palsy and PNI.
Translation and Cross-Cultural Adaptation of the Toronto Extremity Salvage Score (TESS) for Latin American Spanish-Speaking Patients With Limb Sarcoma: Latin American Spanish TESS Adaptation.
Ceballos O, Cabrolier J, Chehade B … +4 more , Hardoy F, Cortes F, Tolosa R, Wevar O
Int J Surg Oncol · 2024 · PMID 39545165 · Full text
This study aims to translate and culturally adapt the Toronto Extremity Salvage Score (TESS) for Latin American Spanish-speaking patients, enhancing the tool's accessibility for evaluating postsurgical functional outcome...
This study aims to translate and culturally adapt the Toronto Extremity Salvage Score (TESS) for Latin American Spanish-speaking patients, enhancing the tool's accessibility for evaluating postsurgical functional outcomes in sarcoma patients across Latin America. The TESS questionnaires for lower extremity (LE) and upper extremity (UE) were translated and adapted following international guidelines. The process included forward and backward translation, expert committee review, and pretesting with cognitive interviewing. Patients treated for bone or soft tissue tumors in LE or UE were recruited to complete the adapted questionnaires. Test-retest reliability was evaluated by having participants complete the questionnaire again 2 weeks after the initial assessment. A total of 89 participants completed the questionnaires. The study found high internal consistency, with Cronbach's alpha values reaching 0.9437 for LE and 0.9402 for UE. An agreement rate of 98.4% for the global score of TESS-LE (95% confidence interval [CI]: 0.909-1.059) and 93.9% for TESS-UE (95% CI: 0.882-0.995) was observed, demonstrating strong test-retest reliability. The Latin American Spanish version of TESS for both lower and upper extremities is a reliable and culturally appropriate tool for assessing physical function in limb sarcoma patients. Further validation across diverse Latin American populations is encouraged to strengthen its broad applicability.
The Sublingual Gland Flap for Oral Reconstruction: Insights From a Single Institutional Experience.
Wieczorkiewicz A, Kuczera J, Hramyka A … +4 more , Śliwiński K, Bargiel J, Wyszyńska-Pawelec G, Gontarz M
Int J Surg Oncol · 2024 · PMID 39445029 · Full text
Following ablative surgery, the reconstruction of oral cavity defects is essential to ensure optimal function and aesthetically acceptable outcomes. The purpose of this study was to retrospectively analyze the effectiven...
Following ablative surgery, the reconstruction of oral cavity defects is essential to ensure optimal function and aesthetically acceptable outcomes. The purpose of this study was to retrospectively analyze the effectiveness and complication rates of the sublingual gland flap (SGF) in oral soft tissue reconstruction. The procedure for harvesting SGF and the strengths and limitations of the flap are discussed. The study group consisted of 13 patients suffering from oncological diseases who underwent soft tissue reconstruction with SGF. The patient's medical charts were evaluated based on histopathological aspects, postoperative complications, and outcomes. Reconstruction of the floor of the mouth was performed in 8 patients (61.5%) and lower gingiva in 5 patients (38.5%), respectively. Complete epithelialization with closure of the defect was achieved within an average of 2 weeks. The observation period ranged from 1 to 33 months, with an average duration of 11.5 months. Partial flap necrosis and ranula occurred in one patient (7.7%). Furthermore, postoperative bleeding was observed in one patient (7.7%), and wound dehiscence and abscess formation were noted in another (7.7%). Locoregional recurrence of the cancer was observed in one case (7.7%). The SGF is effective for achieving successful reconstruction of small- and medium-sized defects in the lower gingiva and floor of the mouth. The complication rate is relatively low.
Novel Index Combining Pan-Immune-Inflammatory Index and Hemoglobin Levels (PIV/Hb) Predicts Trismus Rates Efficiently after Chemoradiotherapy in Locally Advanced Nasopharyngeal Cancer.
Somay E, Yilmaz B, Topkan E … +5 more , Ozdemir BS, Ozturk D, Besen AA, Mertsoylu H, Selek U
Int J Surg Oncol · 2024 · PMID 39376995 · Full text
PURPOSE: To evaluate the predictive potency of a novel index combining the pan-immune-inflammatory index and hemoglobin levels (PIV/Hb) for the prevalence of radiation-induced trismus (RIT) in patients with locally advan...
PURPOSE: To evaluate the predictive potency of a novel index combining the pan-immune-inflammatory index and hemoglobin levels (PIV/Hb) for the prevalence of radiation-induced trismus (RIT) in patients with locally advanced nasopharyngeal cancer (LA-NPC) receiving concurrent chemoradiotherapy (CCRT). METHODS: Data from 228 LA-NPC patients were retrospectively examined. Maximum mouth openings (MMO) were measured to confirm the presence of RIT, defined as MMOs ≤35 mm. Complete blood test results from the first day of CCRT were used to calculate PIV/Hb levels. A potential relationship between pretreatment PIV/Hb and the RIT status was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: Post-CCRT RIT was diagnosed in 20.2% of the patients. The ROC curve analysis determined 68.4 g/dL as the ideal PIV/Hb cutoff that effectively divided patients into two distinct groups (area under the curve: 94.7%; specificity: 86.4%; sensitivity: 87.4%). RIT was significantly more prevalent in the PIV/Hb > 68 group than in the PIV/Hb < 68 group (58.8% vs. 3.8%; < 0.001). Multivariate logistic regression analysis showed that a pre-CCRT PIV > 68 was independently associated with significantly higher rates of RIT. CONCLUSION: Higher pretreatment levels of the novel PIV/Hb index predict increased RIT rates following definitive CCRT for LA-NPCs.
Risk Factors for Early Postoperative Morbidity and Mortality following Extremity Metastatic Pathologic or Impending Fracture Fixation.
Wang PQ, Charron BP, Hali K … +5 more , Raleigh M, Del Balso C, Macleod MD, Sanders DW, Lawendy AR
Int J Surg Oncol · 2024 · PMID 39301148 · Full text
BACKGROUND: As cancer survivorship continues to improve, the perioperative morbidity and mortality following surgical treatment of metastatic bone disease become an increasingly important consideration. The objective of...
BACKGROUND: As cancer survivorship continues to improve, the perioperative morbidity and mortality following surgical treatment of metastatic bone disease become an increasingly important consideration. The objective of this study is to identify risk factors for early postoperative complications and mortality following extremity prophylactic fixation and pathologic fracture stabilization. METHODS: A single-centre retrospective review of 185 patients (226 total surgeries) who underwent prophylactic fixation or pathologic fracture stabilization for extremity metastatic bone disease between 2005 and 2020 was performed. Skull, spine, pelvic, and revision surgeries along with diagnosis of primary bone neoplasm were excluded. Univariate, multivariate, and subgroup analyses were performed to identify predictors and independent risk factors for 30-day postoperative morbidity and mortality. RESULTS: Primary cancers included lung ( = 41), breast ( = 36), multiple myeloma ( = 35), prostate ( = 16), lymphoma ( = 11), renal cell carcinoma ( = 10), and ( = 36). The 30-day postoperative complication and mortality rates were 32.30% ( = 73) and 17.26% ( = 39), respectively. The most common complications were pulmonary-related, cardiac events, surgical site infection, sepsis, and thromboembolism. Pathologic fracture, presence of extra-skeletal metastases, longer surgical duration, and blood transfusion requirements were associated with 30-day postoperative complications overall. A past medical history for cardiac disease was also associated with systemic but not local surgical complications. Pathologic fracture, presence of extra-skeletal metastases, lung cancer, blood transfusion requirements, and increasing pack-year smoking history were predictors for 30-day mortality. In the multivariate analysis, pathologic fracture (=0.016) and presence of extra-skeletal metastases (=0.029) were independent predictors of complications. For mortality, pathologic fracture (=0.014), presence of extra-skeletal metastases (=0.0085), and increased blood transfusion requirements (=0.048) were independent risk factors. CONCLUSIONS: The findings of this study provide additional guidance for perioperative risk assessment and patient counselling. Additionally, improving clinical assessment tools to identify and quantify patients at risk of pathologic fractures becomes increasingly important given the significant morbidity and mortality associated with pathologic fracture treatment.
Differentiated Thyroid Carcinoma Long-Term Prognostic Factors.
Luis PO, Lucía MA, Hugo RC … +2 more , Ramiro RM, Stalin CQ
Int J Surg Oncol · 2024 · PMID 39291250 · Full text
INTRODUCTION: Thyroid cancer is the most common cancer in women in Ecuador. OBJECTIVE: The aim of this study was to determine the demographics and clinical and treatment variables of patients with papillary or follicular...
INTRODUCTION: Thyroid cancer is the most common cancer in women in Ecuador. OBJECTIVE: The aim of this study was to determine the demographics and clinical and treatment variables of patients with papillary or follicular thyroid cancer, referred to as differentiated thyroid cancer (DTC), treated at a third-level hospital in Quito, Ecuador. METHODS: We reviewed retrospectively the medical records of patients with DTC, who underwent surgical treatment, from 1990 to 2019. Data included demographics, pathological information, clinical stage, type of surgery, and radioactive iodine (RAI) adjuvant therapy. Patients were monitored for up to 29 years (median follow-up time 6.9 years). RESULTS: The corrected overall 5-, 10-, 20-, and 30-year survival rates (Kaplan-Meier) were 93%, 85%, 70%, and 63%, respectively. On univariate analysis, age, histological type, tumor grade, histological variants, capsular invasion, vascular invasion, tumor size, clinical stage, distant metastases at diagnosis, surgical margins, extrathyroidal invasion, radioactive iodine adjuvant treatment, and locoregional recurrence were found to be significant prognostic factors. In a multivariate analysis, the following independent variables: age over 55 years, extrathyroidal spread, metastasis at diagnosis, and stage II to IV raised the risk of death (hazard risk) (HR). CONCLUSIONS: Age over 55 years, extrathyroidal spread, metastasis at diagnosis, and advanced clinical stage were found to have a harmful prognosis and an increased risk of death in a series of Ecuadorian patients surgically treated for a DTC.
Risk Factors of Oral Squamous Cell Carcinoma with Special Emphasis on Areca Nut Usage and Its Association with Clinicopathological Parameters and Recurrence.
Hashmi AA, Mudassir G, Rashid K … +4 more , Malik UA, Zia S, Zia F, Irfan M
Int J Surg Oncol · 2024 · PMID 39233744 · Full text
INTRODUCTION: Oral squamous cell carcinoma (OSCC) is the most prevalent type of head and neck cancer and is associated with high mortality, particularly in Southeast Asian countries. Areca nut usage, smoking, and alcohol...
INTRODUCTION: Oral squamous cell carcinoma (OSCC) is the most prevalent type of head and neck cancer and is associated with high mortality, particularly in Southeast Asian countries. Areca nut usage, smoking, and alcohol consumption are the most common risk factors for OSCC. Areca nut chewing is highly prevalent in Pakistan and has been attributed to an increase in OSCC cases. This study aimed to determine the association between areca nut usage and various clinicopathological features of OSCC and further evaluate the association of clinicopathological parameters of OSCC with tumor recurrence. MATERIALS AND METHODS: The study was conducted using the data of 228 patients with OSCC resected at Liaquat National Hospital, Karachi, Pakistan, over 5 years between 2018 and 2022. Clinicopathological data were collected from hospital archives, and associations between various risk factors and clinicopathological parameters were determined. RESULTS: Males were more commonly affected (77.2%), and the most common age group was <50 years (54.4%). Areca nut usage was reported in 59.6% of cases, and the buccal mucosa was the most common site (62.7%). Areca nut usage was significantly associated with male gender, greater tumor size, greater depth of invasion (DOI), higher tumor stage, nodal stage, presence of perineural invasion (PNI), and recurrence. In addition, multivariate analysis revealed that OSCC recurrence was significantly associated with older age, larger tumor size and DOI, nodal metastasis, and areca nut usage. CONCLUSION: Areca nut-related OSCCs were associated with poor prognosis and recurrence in our study population. Furthermore, OSCC recurrence was associated with various clinicopathological parameters, such as larger tumor size, a higher DOI, and nodal metastasis.
Cost-Effectiveness of Routine Histopathological Analysis of Doughnuts after Colorectal Surgery Three-Year Single-Centre Experience.
Ur Rehman M, Moussa R, Siaw Lin C … +4 more , Ahmed N, Rehman A, Malik K, Ahmed J
Int J Surg Oncol · 2024 · PMID 39188852 · Full text
AIM: This study aimed to assess the impact of routine histological examination of stapled colorectal anastomotic doughnuts in patients undergoing rectal cancer surgery (RCS). Justification of biopsy examination could for...
AIM: This study aimed to assess the impact of routine histological examination of stapled colorectal anastomotic doughnuts in patients undergoing rectal cancer surgery (RCS). Justification of biopsy examination could form part of the strategies of NHS net zero practice with effort to reduce wastage and carbon footprint. METHOD: A data analysis of all patients undergoing RCS during 2019-2021 at our institute was performed. We also analysed the cost of preparing and reviewing histology slides. RESULTS: 52 patients underwent anterior resection during the aforementioned period. Doughnuts were sent in 37 (71%) patients. 23 (62%) patients were male, and 14 (38%) were female. The median age at diagnosis was 68 (range 54-84) years. All resected specimens were adenocarcinomas. Of the 37 patients, 18 (49%) underwent low anterior resection and 19 (51%) underwent high anterior resection. Proximal doughnuts were sent in 26 (70%) patients, whereas distal doughnuts were sent in all cases. Mean distal microscopic resection margin from tumour was 22 mm (range 6-45 mm). Each doughnut required 3 slides, each costing £50 and requiring 82 minutes to fix and read. This incurred a cost of £13,650 and required 19,656 hours of preparation time. All of the doughnuts as well as resection margins were negative for malignancy. CONCLUSION: Routine histopathological examination of doughnuts is time and cost-intensive however provides little or no clinical value (particularly analysis of the proximal doughnut). Distal doughnuts should only be sent for histological examination in exceptional circumstances.
Transanal Intubation for Preventing Colorectal Anastomotic Failure.
Gordiichuk M
Int J Surg Oncol · 2024 · PMID 39157264 · Full text
INTRODUCTION: Failure of low colorectal anastomosis remains challenging in surgical oncology, necessitating the exploration of new methods and improvements in existing preventive measures. MATERIALS AND METHODS: This pro...
INTRODUCTION: Failure of low colorectal anastomosis remains challenging in surgical oncology, necessitating the exploration of new methods and improvements in existing preventive measures. MATERIALS AND METHODS: This prospective study was conducted in two stages: intraluminal pressure in the colon was monitored in 32 patients by manometry and sonography over a 5-day postoperative period; 213 patients who underwent anterior resection of the rectum were analyzed, of whom 126 and 87 underwent diverting stoma (DS) and transanal intubation (TAI), respectively. RESULTS: The effectiveness of the recommended technique for applying and removing transanal intubation (TAI) to prevent pneumo hydro strike (≥15 kPa) on the anastomosis line was analyzed in 87 patients and compared with imposed DS. TAI showed better borderline statistical significance ( = 0.051). The incidence of repeat surgery for anastomotic failure (AL) was seven (5.55%) and four (4.59%) in the DS and TAI groups, respectively. The distance of the anastomosis from the dentate line <60 mm was associated with a higher risk of AL occurrence (odds ratio (OR), 1.012; 95% confidence interval (CI), 1.007-1.017; < 0.001; area under the curve (AUC) = 0.82). DS is recommended for men, as the risk of AL is significantly lower among women (OR, 0.41; 95% CI, 0.16-1.04; = 0.062; AUC, 0.61; 95% CI, 0.54-0.67). CONCLUSIONS: Although TAI is advantageous over DS for preventing AL, surgeons select the method for the preventive approach based on the preoperative and intraoperative results.
Histopathologic Features of Mucosal Head and Neck Cancer Cachexia.
Jones AJ, Novinger LJ, Bonetto A … +6 more , Davis KP, Giuliano MM, Mantravadi AV, Sim MW, Moore MG, Yesensky JA
Int J Surg Oncol · 2024 · PMID 38966634 · Full text
OBJECTIVE: Determine the histopathologic features that correlate with head and neck cancer (HNC) cachexia. METHODS: A single-institution, retrospective study was performed on adults with HPV-negative, mucosal squamous ce...
OBJECTIVE: Determine the histopathologic features that correlate with head and neck cancer (HNC) cachexia. METHODS: A single-institution, retrospective study was performed on adults with HPV-negative, mucosal squamous cell carcinoma of the aerodigestive tract undergoing resection and free flap reconstruction from 2014 to 2019. Patients with distant metastases were excluded. Demographics, comorbidities, preoperative nutrition, and surgical pathology reports were collected. Comparisons of histopathologic features and cachexia severity were made. RESULTS: The study included 222 predominantly male (64.9%) patients aged 61.3 ± 11.8 years. Cachexia was identified in 57.2% patients, and 18.5% were severe (≥15% weight loss). No differences in demographics were identified between the groups. Compared to control, patients with severe cachexia had lower serum hemoglobin (=0.048) and albumin ( < 0.001), larger tumor diameter ( < 0.001), greater depth of invasion ( < 0.001), and elevated proportions of pT4 disease ( < 0.001), pN2-N3 disease (=0.001), lymphovascular invasion (=0.009), and extranodal extension (=0.014). Multivariate logistic regression identified tumor size (OR [95% CI] = 1.36 [1.08-1.73]), oral cavity tumor (OR [95% CI] = 0.30 [0.11-0.84]), and nodal burden (OR [95% CI] = 1.16 [0.98-1.38]) as significant histopathologic contributors of cancer cachexia. CONCLUSIONS: Larger, more invasive tumors with nodal metastases and aggressive histologic features are associated with greater cachexia severity in mucosal HNC.
The Role of Colon in Isolated Intestinal Transplantation: Description of 4 Cases.
Di Cocco P, Bencini G, Martinino A … +7 more , Petrochenkov E, Akshelyan S, Yoshikawa K, Spaggiari M, Almario-Alvarez J, Tzvetanov I, Benedetti E
Int J Surg Oncol · 2024 · PMID 38910955 · Full text
Intra-abdominal desmoid tumors are a rare and complex clinical problem. These tumors are locally invasive, and surgical ablation represents the mainstay of treatment. When localized at the root of the mesentery, their re...
Intra-abdominal desmoid tumors are a rare and complex clinical problem. These tumors are locally invasive, and surgical ablation represents the mainstay of treatment. When localized at the root of the mesentery, their resection may require extensive excision of the intestine resulting in intestinal failure and life-long total parenteral nutrition. Intestinal transplantation, either autotransplantation or allotransplantation, has been used as a viable option to treat this group of patients. Herein, we describe a series of 4 patients with unresectable intra-abdominal desmoid tumor who underwent cadaveric isolated intestinal and ascending colon transplantation.
Total Mesorectal Excision with or without Lateral Pelvic Lymph Node Dissection in Rectal Cancer.
Elbarmelgi MY, Abdelaal AM, Refaie O … +2 more , Tamer M, Shafik AA
Int J Surg Oncol · 2023 · PMID 38173914 · Full text
RESULTS: Incidence of local recurrence was slightly higher in Group A (8.7%) than in Group B (4.3%) but was not statistically significant. There was no statistical significance between both groups regarding distant metas...
RESULTS: Incidence of local recurrence was slightly higher in Group A (8.7%) than in Group B (4.3%) but was not statistically significant. There was no statistical significance between both groups regarding distant metastasis (8.7% in Group A and 13% in Group B). Urinary and sexual dysfunctions were higher in Group B (26.1%) compared to those in Group A (21.7%) but were not statistically significant. The incidence of lateral pelvic lymph node metastasis was 30.4%. Also, intraoperative blood loss was higher and operative time was longer in Group B which was statistically significant ( value <0.001). CONCLUSION: Our conclusion was that prophylactic addition of LPLD to TME was not associated with a statistically significant decrease in the risk of local recurrence or distant metastasis in patients with rectal cancer, although it was numerically better. LPLD is associated with longer operative time and higher intraoperative blood loss.
The Beneficial Impact of Intraoperative Ultrasound on Resection Margin Status during Breast Conserving Surgery.
Almezaien O, Mohamed Eldeeb A, Kalmoush A … +7 more , Shaaban Nassar M, Zaghlol Mohamed T, Sobhy Shaaban M, Ibrahim Henish M, Teama S, Abdolmonem Elgohary Khalafallah S, Ibrahim LA
Int J Surg Oncol · 2022 · PMID 36531148 · Full text
BACKGROUND: Surgical resection with clear surgical cut margins is the mainstay of managing malignant breast neoplasms. Multiple techniques have been suggested to enhance resection status during breast-conserving surgery...
BACKGROUND: Surgical resection with clear surgical cut margins is the mainstay of managing malignant breast neoplasms. Multiple techniques have been suggested to enhance resection status during breast-conserving surgery (BCS), including intraoperative ultrasonography (IOUS). Herein, we conducted the current investigation to reveal the benefit of IOUS on the achievement of R0 resection. . This retrospective investigation included 140 patients who underwent BCS. They were divided into two groups: the IOUS group (40 cases) and the control group (100 cases). Our primary objective was to determine the free resection margin status (R0). RESULTS: Both study groups expressed statistically comparable demographic and clinical data. Additionally, histopathological examination revealed no significant difference between the two groups regarding the tumor type, stage, or grade. Nonetheless, the R0 resection margin was more frequently encountered in association with IOUS application (97.5% compared to 79% in the control group), and that difference was statistically significant (=0.007). CONCLUSION: The application of IOUS has a significant beneficial impact on the outcomes of BCS. It is associated with a marked decline in positive resection margins, and its application should be encouraged in the breast oncological practice.
Incidence and Risk Factors of Thyroid Malignancy in Patients with Toxic Nodular Goiter.
Mohamed TZ, Sultan AAEA, Tag El-Din M … +8 more , Mostafa AAE, Nafea MA, Kalmoush AE, Nassar MS, Abdalgaleel MA, Hegab AM, Ibrahim AH, Baheeg M
Int J Surg Oncol · 2022 · PMID 35656410 · Full text
BACKGROUND: Although hyperfunctioning thyroid disorders were thought to be protective against malignancy, some recent studies reported a high incidence of incidentally discovered cancer in patients with hyperfunctioning...
BACKGROUND: Although hyperfunctioning thyroid disorders were thought to be protective against malignancy, some recent studies reported a high incidence of incidentally discovered cancer in patients with hyperfunctioning benign thyroid disorders. We performed this study to estimate the incidence and predictors of malignant thyroid disease in patients with toxic nodular goiter (TNG). . The data of 98 patients diagnosed with TNG were reviewed (including toxic multinodular goiter SMNG and single toxic nodule STN). The collected data included patients age, gender, systemic comorbidities, family history of thyroid malignancy, previous neck radiation, type of disease (multinodular or single), size of the dominant nodule by the US, operative time, and detection of significant lymph nodes during operation. Based on the histopathological analysis, the cases were allocated into benign and malignant groups. RESULTS: Malignancy was detected in 21 patients (21.43%). Although age distribution was comparable between the two groups, males showed a significant increase in association with malignancy. Medical comorbidities and family history of cancer did not differ between the two groups. However, TMNG showed a statistically higher prevalence in the malignant group. Operative data, including operative time and lymph node detection, were comparable between the two groups. On regression analysis, both male gender and TMNG were significant predictors of malignancy. CONCLUSION: The presence of thyroid hyperfunction is not a protective factor against malignancy, as malignancy was detected in about 1/5 of cases. Male gender and TMNG were significant risk factors of malignancy in such patients.
Assessment of Quality of Life (QoL) of Colorectal Cancer Patients using QLQ-30 and QLQ-CR 29 at King Abdulaziz Medical City, Jeddah, Saudi Arabia.
Qedair JT, Al Qurashi AA, Alamoudi S … +2 more , Aga SS, Y Hakami A
Int J Surg Oncol · 2022 · PMID 35619894 · Full text
OBJECTIVE: We aimed to assess the quality of life (QoL) and its predictors in colorectal cancer (CRC) patients at King Abdulaziz Medical City, Jeddah. METHODS: A total of 118 CRC patients at King Abdulaziz Medical City,...
OBJECTIVE: We aimed to assess the quality of life (QoL) and its predictors in colorectal cancer (CRC) patients at King Abdulaziz Medical City, Jeddah. METHODS: A total of 118 CRC patients at King Abdulaziz Medical City, a tertiary hospital in Jeddah, participated in this study. The participants were provided with the online questionnaire via WhatsApp by trained researchers and data collectors in February 2021. All participants were required to answer the three-section questionnaire comprising of (a) demographic data and a validated Arabic version of the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaires, (b) a general version (QLQ-30), and (c) a CRC-specific version (QLQ-CR29). RESULTS: Statistical analysis revealed that the most common comorbidity among the participants was diabetes mellitus (42.4%). In addition, the mean global health status was 63.91 ± 24.75. For the global health tool QLQ-C30, results exhibited that physical functioning [62.94 (30.04)] and social functioning [63.56 (31.95)] scored below the threshold, while the cognitive functioning scale scored the highest [74.86 (25.11)]. In addition, on the QLQ-C30 scales, fatigue and insomnia were distressing, with fatigue scoring the highest. For the disease-specific tool QLQ-CR29, it was found that for the symptom scale, urinary frequency and embarrassment scored the highest. Conclusion. The participants reported high global quality of life on both the EORTC QLQ-30 and QLQ-CR29 scales. This study identifies the factors and predictors that affect the quality of life of CRC patients in Saudi Arabia. Recognizing these factors and predictors may empower those patients to maintain positive perception towards the impact of colorectal cancer and improve their survival.
High CD44 Immunoexpression Correlates with Poor Overall Survival: Assessing the Role of Cancer Stem Cell Markers in Oral Squamous Cell Carcinoma Patients from the High-Risk Population of Pakistan.
Adnan Y, Ali SMA, Farooqui HA … +3 more , Kayani HA, Idrees R, Awan MS
Int J Surg Oncol · 2022 · PMID 35296132 · Full text
Oral squamous cell carcinoma (OSCC) is a top-ranked cancer in the Pakistani population, and patient survival has remained unchanged at ∼50% for several decades. Recent advances have claimed that a subset of tumour cells,...
Oral squamous cell carcinoma (OSCC) is a top-ranked cancer in the Pakistani population, and patient survival has remained unchanged at ∼50% for several decades. Recent advances have claimed that a subset of tumour cells, called cancer stem cells (CSCs), are responsible for tumour progression, treatment resistance, and metastasis, which leads to a poor prognosis. This study investigated the impact of CSC markers expression on overall survival (OS) and disease-free survival (DFS) of OSCC patients. . Immunohistochemistry was used to evaluate CD44, CD133, L1CAM, and SOX2 expression in a well-characterized cohort of 100 Pakistani patients with primary treatment naïve OSCC. The immunoreactivity for each marker was correlated with patient clinicopathologic characteristics, oral cancer risk chewing habits, and survival. The minimum follow-up time for all patients was five years, and survival estimates were calculated using the Kaplan-Meier method and Cox proportional hazards model. . In this cohort of 100 patients, there were 57 males and 43 females. The median OS and DFS time durations observed were 64 and 52.5 months, respectively. Positive expression for CD44, CD133, L1CAM, and SOX2 was observed in 33%, 23%, 41%, and 63% of patients. High CD44 expression correlated with decreased OS (=0.047) but did not influence DFS. However, CD133, L1CAM, and SOX2 had no effect on either OS or DFS. Tonsils, nodal involvement, and AJCC stage were independent predictors of worse OS and DFS both. . Of the CSC markers investigated here, only CD44 was a predictor for poor OS. CD44 was also associated with advanced AJCC and T stages. Interestingly, CD133 was significantly lower in patients who habitually consumed oral cancer risk factors.
Prognostic Impact of Tumor Budding on Moroccan Colon Cancer Patients.
El Agy F, El Bardai S, Bouguenouch L … +9 more , Lahmidani N, El Abkari M, Benjelloun EB, Ousadden A, Mazaz K, ImaneToughrai, Ibrahimi SA, Benbrahim Z, Chbani L
Int J Surg Oncol · 2022 · PMID 35096426 · Full text
BACKGROUND: Tumor budding is now emerging as one of the robust and promising histological factors that play an important role in colon cancer. In this study, we aimed to investigate the association between tumor budding...
BACKGROUND: Tumor budding is now emerging as one of the robust and promising histological factors that play an important role in colon cancer. In this study, we aimed to investigate the association between tumor budding and tumor clinicopathological factors, tumor molecular signature, and patient survival for the first time in a Moroccan population. METHODS: We collected data of 100 patients operated from colon adenocarcinoma. Tumor budding was assessed on HES slides, according to the International Tumor Budding Consensus Conference 2016 recommendations. The expression of MMR proteins was performed by immunohistochemistry. KRAS and NRAS mutations testing was performed by Sanger sequencing and pyrosequencing. RESULTS: High tumor budding grade (BUD 3) was found to be significantly associated with adverse clinicopathological features including older age (=0.03), presence of perineural invasion (=0.02), presence of vascular invasion (=0.05), distant metastases ( < 0.001), advanced TNM stage (=0.001), the occurrence of relapse (=0.04), and the high number of deceased cases (=0.02). Interestingly, we found that tumors with high-grade tumor budding were more likely to be microsatellite stable (MSS) (=0.005) and harbor more KRAS mutations (=0.02). Tumors with high-grade tumor budding were strongly associated with KRAS G12D mutation (=0.007). In all stages, high tumor budding was correlated with poorer overall survival (=0.04) and decreased relapse-free survival with a difference close to significance ((=0.09). We concluded that high tumor budding was strongly associated with unfavorable clinicopathological features and special molecular biomarkers and effectively affects the overall survival of CC patients. CONCLUSIONS: Based on these findings and the ITBCC group recommendations, tumor budding should be taken into account along with other clinicopathologic factors in the risk assessment of colorectal cancer.
Comparing Emergent and Elective Colectomy Outcomes in Elderly Patients: A NSQIP Study.
El Edelbi M, Abdallah I, Jaafar RF … +3 more , Tamim H, Deeba S, Doughan S
Int J Surg Oncol · 2021 · PMID 34912578 · Full text
INTRODUCTION: With the increasing prevalence of colorectal cancer (CRC) worldwide, especially in the elderly, and the variability between physiological and chronological age and its impact on functional status, acute sym...
INTRODUCTION: With the increasing prevalence of colorectal cancer (CRC) worldwide, especially in the elderly, and the variability between physiological and chronological age and its impact on functional status, acute symptoms leading to emergent surgery due to colorectal malignancy may lead to increased morbidity and mortality. The aim of this study is to identify the outcome differences of elective vs. emergent open colectomy in patients above 80 years. METHODS: The National Surgical Quality Improvement Program (NSQIP) database was reviewed from 2010 to 2014 for open colectomy based on CPT codes. Comparison between groups was done based on the clinical context at presentation as elective or emergent surgery. Data were analyzed using SAS. RESULTS: Elective colectomies were performed in 8289 (70.8%) vs. emergent colectomies in 3409 (29.1%). Emergent colectomy patients had higher American Society of Anesthesiologists (ASA) preoperative classification III-IV, 1429 (42.0%) and 224 (6.6%), vs. 1238 (14.9%) and 21 (0.2%) in elective colectomy patients ( < 0.0001). Emergent colectomy patients had more comorbidities such as chronic obstructive pulmonary disorder (493 (14.5%) vs. 796 (9.6%)), congestive heart failure (206 (6.0%) vs. 310 (3.8%)), dialysis (106 (3.1%) vs. 56 (0.7%)), and acute renal failure (166 (4.9%) vs. 46 (0.6%)) ( < 0.0001), respectively. Postoperative morbidity and mortality were significantly higher in emergent colectomy (1651 (48.4%) and 872 (25.6%)) vs. elective colectomy (1859 (22.4%) and 567 (6.8%)) ( < 0.0001), respectively. CONCLUSION: Emergent open colectomy in elderly patients carries a higher risk of morbidity and mortality when compared to elective open colectomy with risk factors being higher ASA classification and more comorbidities.
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