bluuebunny/crossref_metadata_2025_split huggingface dataset:
Morbidity and mortality after colorectal cancer surgery in patients with cirrhosis: A critical review of the literature.
Authors: Boussaha Tarek , Cadranel Jean François , Smail Allaoua , Lison Hortensia , Garioud Armand , Carola Elisabeth , Dumont Sarah Naomie , Chibaudel Benoist , André Thierry , Parc Yann 
Published: February 2017

608 Background: Cirrhotic patients with localized colorectal cancer are potential candidates for tumor resection. The aim of this review was to evaluate the morbi-mortality after colorectal surgery. Methods: Comprehensive search was conducted using PUBMED, EMBASE, and the COCHRANE Library. Prospective and retrospective studies were selected. The study population included cirrhotic patients who underwent colorectal resection for non-metastatic colorectal cancer and patients with benign and other malignant disease. The postoperative morbi-mortality and independent risk factors were analysed. Results: Eight studies were identified. Among these, four studies compared the risk of colorectal surgery in patients with and without liver cirrhosis. The number of patients varied from 41 to 6,120. The severity of cirrhosis in most of the studies was classified with the Child-Pugh score. Class B and C were observed in 20% to 60% of the patients. Sepsis represented the main postoperative complication and occurred in 48% to 77% of patients. Mortality varied according to the Child-Pugh score, ranging from 11% to 41%, and was significantly higher for patients with cirrhosis in Child-Pugh Class C. Urgent surgical procedure had a negative impact on prognosis. The average length of hospital stay ranged from 9 to 18 days. Cirrhosis was associated with a 2-3 time and a 4-10 time increased risk of postoperative mortality in the absence and presence of portal hypertension, respectively compared with non-cirrhotic patients. The independent risk factors for postoperative morbidity and mortality were encephalopathy, ascites, low haemoglobin, prolonged prothrombin time, elevated bilirubin, hypoalbuminemia, postoperative infection, total colectomy, elective or non-elective surgery, the presence of co-morbidities and MELD score ≥ 15. Conclusions: Colorectal cancer surgery is associated with an increased risk of postoperative morbidity and mortality in cirrhosis patients. Studies evaluating exclusively the operative risk for colorectal cancer surgery in this patient’s population are rare. Prospective controlled trials to optimize the perioperative management of those patients are needed.
Pelvic side wall nodes in locally advanced rectal cancer as a prognostic indicator.
Authors: Laws Kirsten Elizabeth Jean , Wilson Christina , Harrow Stephen 
Published: February 2017

613 Background: Neoadjuvant long course chemoradiotherapy is a well recognised treatment in locally advanced rectal cancer. Patients with pelvic side wall nodes are often considered for neoadjuvant treatment. We investigated whether pelvic side wall nodes identified on pre-treatment imaging is a poor prognostic factor and whether there are different patterns of recurrence compared to patients without pelvic side wall node involvement. Methods: All patients treated with long course chemoradiotherapy between January 2008 and December 2009 were identified. Patients were excluded if treatment indication was for inoperable disease, postoperative, recurrence, or palliative intent. 231 patients were identified and a retrospective analysis performed investigating patterns of recurrence and survival for patients with pelvic side wall nodes identified on pre-treatment imaging. Results: Kaplan Meier curves are presented showing patients with pelvic side wall nodes identified on pre-treatment imaging appear to have poorer outcomes and overall survival compared with those with only mesorectal nodes or no nodes. Patterns of recurrence are presented, showing patients with pelvic side wall nodes identified on pre-treatment imaging have a non significant trend to increased rates of disease recurrence (local and distal recurrence combined, 45.7% versus 27.9% for pelvic side wall nodes versus no pelvic side wall nodes). Patients with pelvic side wall nodes identified on pre-treatment imaging appear to be more likely to develop distant metastases compared to those patients who have mesorectal nodes or no nodal involvement (37% versus 23%). Conclusions: Our study highlights that patients with pelvic side wall nodes identified on pre-treatment imaging appear to have a trend to poorer overall survival, are more likely to recur and develop distant metastases. These results were not statistically significant, due to the small number of patients, and the data is consequently limited. We intend to further investigate current management strategies for this subgroup of patients, with assessment of radiotherapy treatment plans, current use of integral boosts, and surgical procedures for this subgroup of patients.
Comparative analysis of the effectiveness of second-line bevacizumab plus chemotherapy in second-line therapy in metastatic colorectal cancer.
Authors: Smagulova Kaldigul 
Published: February 2017

619 Background: Advances in molecular biology and a wide introduction to the practice of targeted therapies have improved outcomes and significantly affect the overall survival of patients. To investigate the efficacy and safety of bevacizumab (BEV) beyond first progression combined with chemotherapy (CT) in patients with metastatic colorectal cancer. Methods: 68 patients with mCRC who received chemotherapy treatment at the Department of the Kazakh Research Institute of Oncology and Radiology. Selecting second-line chemotherapy based on oxaliplatin or irinotecan depended of an earlier first-line therapy (FOLFOX, FOLFIRI). The survival rate was calculated by Kaplan-Meier, comparison of survival curves was performed by log-rank. Results: The study included 68 patients, who were randomized from February 2009 to November 2011(to 33 [48.5%] BEV + CT and 35 [51.5%] to CT alone). Analysis of the immediate results of treatment showed that in neither case was not achieved complete response of the tumor. Partial regression in group 1 – 11 (33.3 ± 8.2)%, and group 2 - in 9 (25.7 ± 7.3)%. Stabilization is achieved in 20 (60.6 ± 8.5)% and 23 (6.7 ± 8.0)% of cases, respectively. The progression of the disease was observed in the group 1 in 2 (6.1 ± 4.1)% and 3 (8.6 ± 4.7)% of cases. Median progression-free survival (PFS) and overall survival (OS) was 11.5 months (7-16) and 12.2 months in group 1, and 9.7 months (6-13.2) (PFS), 9.1 months(OS) in group 2, respectively. The adverse event profile was consistent with previously reported data for BEV + CT. BEV-related significant adverse events included bleeding grade 3-4 (1.5 %) and venous thrombosis (2.3 %). Conclusions: Our findings demonstrate that BEV + CT continued beyond progression significantly prolong OS and PFS in second-line therapy mCRC.
The impact of treatment intent on overall survival after radiofrequency ablation of colorectal cancer liver metastases: The Royal Marsden Hospital experience.
Authors: Khan Khurum Hayat , Wale Anita , McCall James , Wijesekera Nevin , Khan Nasir , Chau Ian , Brown Gina 
Published: February 2017

622 Background: 50% of patients with colorectal cancer will develop liver metastases (CLM), for many patients this will be the first and only site of metastatic disease. A minority of the patients will undergo surgical resection with curative intent, the remainder may be offered treatment with chemotherapy and local ablative techniques. Radiofrequency ablation (RFA) is increasingly used to treat patients deemed unsuitable for surgery, as an adjunct to or holding procedure before hepatic resection or for patients with recurrent disease. In addition some centres use RFA in the palliative setting. The aim of this study was to determine survival outcomes according to RFA treatment intent in patients with CLM. Methods: Clinical characteristics and survival outcomes of all patients with CLM treated with RFA between 2005-2011 were recorded. Patients were grouped according to the intent with which they underwent their first RFA procedure, namely "curative intent", "holding intent" or "palliative intent". Overall survival was compared between the groups using Kaplan-Meier survival analysis and Log Rank testing. Results: A total of seventy eight pts with CLM (M:F= 44:34), age (median=66, range 43-65 years), who underwent their first RFA procedure between 2005 and 2011 were identified. Thirty pts underwent RFA as a curative procedure (38%), 18 (23%) as a “holding procedure” before hepatic resection and 30 (38%) as a palliative procedure. The median OS for all patients was 25 months after first RFA treatment. Log Rank test showed survival was significantly different according to treatment intent; patients who underwent RFA as a holding procedure before hepatic resection had improved survival over those who underwent RFA with curative intent, who in turn had improved survival over those who underwent RFA with palliative intent (47 vs. 32 vs. 16 months, p = <0.001). Conclusions: Our study demonstrates that patients do best if RFA is used as neo-adjuvant treatment prior to hepatic resection, compared to when it is used as curative or palliative procedure. Careful selection of pts is required to optimise outcomes for the pts receiving RFA.
The impact of histologic tumor response on survival of patients treated with neoadjuvant mFOLFOX6 plus bevacizumab for the synchronous liver metastases from colorectal cancer.
Authors: Katayose Yu , Ishida Kazuyuki , Nakagawa Kei , Yamauchi Junichiro , Oikawa Masaya , Sakurai Naoki , Musha Hiroaki , Shimamura Hiromune , Miura Koh , Motoi Fuyuhiko , Egawa Shinichi , Unno Michiaki 
Published: February 2017

625 Background: The synchronous liver metastases (SLM) from colorectal cancer (CRC) have a poor prognosis. Therefore, we conducted a phase II study of neoadjuvant mFOLFOX6 + bevacizumab for SLM to explore the appropriate initial treatment (BeFORE study). Here, assess the impact of histological tumor response (HR) on the relapse-free survival (RFS) and the overall survival (OS). Methods: The main inclusion criteria of BeFORE study were SLM within 10 nodules and with measurable disease. The primary endpoint was the response rate (RR). The secondary endpoints included R0-liver resection rate, HR, RFS and OS. Patients (pts) were enrolled after R0-resection of the primary CRC and received 8 courses of mFOLFOX6 + BV (the first and last courses were mFOLFOX6 alone). After this neoadjuvant chemotherapy, pts underwent resection of liver metastases within 4-8 weeks. HR was re-assessed on the basis of the tumor regression grade (TRG) which evaluates the extent of fibrosis of tumor cells, and the modified TRG which evaluates the extent of fibrosis and therapeutic-associated necrosis, using resected tumor samples. Results: Between June 2008 and November 2010, 47 pts were enrolled and 44 pts were treated per protocol. The median number of metastases was 2 nodules, and the maximum diameter of tumors was 12.9 cm. The overall RR was 72.7%. Forty pts underwent liver resection and 39 pts had the R0-liver resection. Five pts (12.5%) of resected 40 pts achieved TRG 1-2 (major HR), 5 pts (12.5%) had TRG 3 (partial HR) and 30 pts (75.0%) had TRG 4-5 (no HR). 8 pts (20.0%) achieved mTRG 1-2, 8 pts (20.0%) had mTRG 3, and 24 pts (60.0%) had mTRG 4-5. With a median follow-up of 35 months, the 2-year RFS rate was 27.3% (the median RFS was 10.5 months), and the 2-year OS rate was 88.4%. Here, we perform sub-group analyses of RFS and OS by TRG, mTRG, respectively. Conclusions: The impact of HR (TRG, mTRG) on survival could help us with considering about the appropriateness of neo-adjuvant mFOLFOX6 + BV as the initial treatment for SLM. (This trial is on University hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR); UMIN000001568.) Clinical trial information: UMIN000001568.
Survival by lymph node ratio (IG) in colorectal cancer patients in Oncologos del Occidente from Caldas: Colombia 1997–2012.
Authors: Villegas Mejia Carlos Raul , Rojas Gustavo , Chacon Cardona Jose Arnoby , Sanchez Villegas Tomas 
Published: February 2017

641 Background: Colorectal cancer is the third cause of cancer death in the western world and in Colombia the fifth leading cause. The Caldas State being one of the five with the highest mortality rates. There are many prognostic factors reported in the literature but the clinical stage is the most important mainly determined by the number of involved nodes but exist other factors in their evaluation. It has been proposed Lymph Node Ratio (IG) ( Nro. (+) nodes / Nro. nodes removed x 100) for the analysis of nodal stage but there is controversy about its usefulness in various contexts. Methods: We made a descriptive study of patients with colorectal cancer attending at ONCOLOGOS DEL OCCIDENTE from Caldas - Colombia, who applied the Lymph node ratio (IG) and related to demographic, clinical and others prognostic factors in order to see its relation with overall survival at 5, 10 and 15 years. Results: 333 patients with 66% colon cancer, under 40 years 12% , women 50%, 68% without ACE data prior treatment, 41% on right colon, 49% medium rectum, 44% localized stage, 2% pathological complete response and 3% no classification data. Obstruction (29%), ulceration (25%) and 30% without prognostic factors, 33% had 12 or more lymph nodes removed, 50% N0 (TNM), 21% N2; the resected nodes, positive nodes, relapse, prior ACE and TNM as significant variables, 27% relapsed mainly liver, 50% had nodal index group 1 (0%); group 2 (1-20%) 15%, 14% group 3 (21-40%) and 21% group 4 (> 40%) . Mean follow-up: 53.7 months (SD: 43.8, Range:0 -218 months) and overall survival 64% at 5 years and 54% at 10 and 15 years. Conclusions: With an inadequate number of lymph nodes removed (33%) and multiple prognostic factors, Lymph node ratio is proposed like an independent prognostic factor in patients with colorectal cancer associated with overall survival at 5, 10 and 15 years, on which a therapeutic decision can be based.
Short-term outcomes of laparoscopic surgery after insertion of self-expandable metallic stent as a “bridge to surgery” for left-sided obstructive colorectal cancer.
Authors: Waki Yuhei , Tokuda Kazunori , Obatake Masayoshi , Nagahashi Miya , Hotchi Masanori , Kotegawa Hiroshi , Yoshiyama Hirotsugu , Harada Masamitsu , Kawasaki Hideki 
Published: February 2017

643 Background: Safety and validity of performing laparoscopic surgery after preoperative lavege using the self-expandable metallic stent (SEMS) for left-sided obstructive colorectal cancer were examined. We evaluated the short-term outcome of SEMS insertion compared with laparoscopic surgery without SEMS. Methods: Patients with left-sided colorectal cancer treated by either laparoscopic surgery with stent placement (n = 8) or laparoscopic surgery only (n = 42) in our hospital between April, 2012 and January, 2013 were registered. Short-term outcomes were compared with the two groups about patient characteristics (sex, age, American Society of Anesthesiologists Physical Status, body mass index, prior abdominal surgery), pathological data of patients (tumor location, size of tumor , tumor differentiation, number of harvested lymph nodes, pTNM classification, UICC pathological stage), and operative and post operative results (procedures, conversion, operative time, blood loss, morbidity, solid food intake, postoperative hospital stay, total hospital stay). Results: Except for tumor size in the patient characteristic parameters, there were no statistically significant difference between the two groups. Conversion rate to laparotomy was higher in the stent group (2 versus 1, p = 0.013). There was no difference in operation time, blood loss and postoperative complications between the two groups. Conclusions: Although the long-term oncological result requires further investigation, laparoscopic surgery after self-expandable metallic stent is a safe and feasible treatment as a “brige to surgery” for left-sided obstructive colorectal cancer.
Influence of the localization of the primary tumor in the survival of patients with metastatic colon-rectal cancer treated with bevacizumab.
Authors: Gallego Jimenez Inmaculada , Lopez Ladron Amelia , Morales Pancorbo David , Fernandez Parra Eva , Rodriguez de la Borbolla Maria , Fuentes Pradera Jose , Bernabe Caro Reyes , Salvador Bofill Javier 
Published: February 2017

665 Background: Bevacizumab, a humanized antibody against the molecular target endotelial growth factor VEGF-A, has incorporated to the standard of care of metastatic colon-rectal cancer (mCRC). A recent study has suggested that the left colon localization of the primary tumor may be a factor associated with a poorer survival in individuals treated against mCRC with bevacizumab including chemotherapy. Our objective was to analyze the impact of the localization of the primary tumor on the survival of patients with mCRC treated with bevacizumab. Methods: Prospective cohort study conducted in a tertiary-care hospital in Spain. Twenty-nine consecutive patients with mCRC who started a first-line therapy including bevacizumab were included. Patients were followed up until death, lost to follow-up or the censoring date (31th August, 2013). The primary end-point of the study was death from any cause. Predictors of survival, including the localization of the primary tumor, were assessed. Results: The median (Q1-Q3) age was 59 (52-67) years and 13 (45%) patients were male. Chemotherapy scheme was XELOX in 13 (45%) patients, FOLFOX in 8 (28%), FOLFIRI in 5 (17%), XELIRI in 2 (7%) and capecitabine in 1 (3%) patient. The localization of the primary tumor were distributed as follows: rectum in 6 (21%), sigmoid colon in 9 (31%), left colon in 9 (31%) and right colon in 5 (17%) patients. After a median (Q1-Q3) follow-up of 29 (13-41) months, 19 (66%) patients died. There were no patients lost to the follow-up. The mean (SD) survival in patients with left colon cancer was 25 (8) months whereas it was 47 (7) months in the remaining population (p = 0.1). The low sample size precluded to perform reliable multivariate analyses. Conclusions: Our study suggests that left colon localization of the primary tumor may have a worse prognosis in patients with mCRC treated with bevacizumab. Although no statistically significant differences have been observed, this fact may have been a consequence of the limited power of the analysed sample. Collaborative studies should be perfomed in order to clarify this issue.
The management of colorectal cancer (CRC) liver metastases with yttrium-90 microspheres (Y90): The south Australian (SA) experience.
Authors: Karapetis Christos Stelios , Padman Sunita Jo-Anne , Beeke Carol , Padbury Robert , Kitchener Michael , Kirkwood Ian , Voyvodic Frank , Ayres Oliver , Price Timothy Jay 
Published: February 2017

666 Background: Treatment of CRC liver metastases with Y90 may provide a survival benefit but remains under investigation. We report on the accumulated SA clinical experience of using Y90 in the treatment of patients with metastatic CRC. Methods: Data from the SA mCRC Database was used to analyse the baseline characteristics of patients treated with Y90 to determine patterns of care. Safety and adverse outcomes, tumour response, disease progression, and survival were also examined. Survival outcomes were analysed using Kaplan Meier estimates, and chi square testing used for comparisons. Results: 33 patients received Y90, with median age 67 (range 33-83), 25 male, 29 colon/4 rectal primary, 25 hepatic only metastatic disease. Systemic therapy pre Y90 was as follows; nil=4, 1 line=7, 2 lines=9, ≥3=11, unknown=2. There were no immediate Grade III/IV adverse events, though immediate toxicity occurred in 9 patients; liver capsule pain in 8, chest pain and vomiting in 1 patient. Following Y90 treatment, radiologist reported response showed: measurable reduction =3 (ORR 9%), SD=4, PD=20, and 1 patient unknown. Treatment beyond Y90; nil=16 patients, 1 line=7, 2 lines=7 and >3=2 patients. Data on hepatic progression free survival (PFS) and overall PFS is currently being analysed. Median survival from the time of Y90 treatment was 10.3 months. Conclusions: Our data show Y90 use in SA occurs most often after 2 lines of chemotherapy. No immediate grade 3/4 toxicity was encountered. Survival for this select group appears longer than expected. Data on mOS from delivery of Y90, hepatic PFS and overall PFS for subgroups will be reported.
Evaluation of the frequency of c-Met and HER2 expressions in gastric carcinoma and their association with clinicopathologic factors.
Authors: Yalcin Suayib , Yildiz Yetkin , Sokmensuer Cenk 
Published: February 2017

72 Background: Met and HER-2 protoonkogenes encode a receptor tyrosin kinase c-Met and HER-2. We aimed to determine the frequency of c-Met and HER-2 overexpression in gastric cancer and investigated their association with clinicopathological factors. Methods: Patients withstage I-IV disease were analyzed. Overexpressions of c-Met and HER-2 were determined with immunohistochemistry. Results: A total of 143 patients, 97 male 46 female were enrolled. C-Met score was 3 (+) in 31.5 %, 2 (+) in 27.3% and 1 (+) in 10.5% of the patients. There was no statistically significant differences in age, sex, tumor location, differentiation, Lauren classification, TNM staging, presence of distant metastasis, depth of tumor invasion (T), lymphovascular invasion, and survival between c-Met subgroups. HER-2 was 3(+) in 9.1%, 2(+) in 9.8%, and 1(+) in 16.1% of the patients. HER-2 overexpression was associated with better differentiation, intestinal subtype and advanced stage. C-Met overexpression was 84.6% in HER-2 3(+), 64.3% in HER-2 2(+), 69.6%, HER-2 1 (+) and 51.6% in HER-2 (-) patients. There was no statistically significant difference in survival between the c-Met overexpression positive and negative Stage III and IV patients. The median survival was 11.6 ± 6.3 months in HER-2 overexpression positive Stage IV patients and 11.9±6.8 months in HER-2 overexpression negative stage IV patients. There were no statistically significant differences in survival between the two groups. Conclusions: There is an association between c-Met positivity and HER-2 overexpression. C-Met was not associated with any negative prognostic factors in gastric cancer.