Do metastatic colorectal cancer patients who present with late relapse after curative surgery have a better survival?

BackgroundPatients who relapse after potentially curative surgery for colorectal cancer tend to relapse within 5 years. There is, however, a group of patients who relapse beyond 5 years after resection and this late relapsing group may have a different behaviour and prognosis.MethodsWe analysed data from a prospective population-based registry to compare the characteristics and survival of relapsed patients with metachronous mCRC. Patients were categorised into relapse at 5 years following their initial surgery. Univariate log-rank tests and multivariate Cox regression was performed to determine whether time to relapse (TTR) and other factors were associated with overall survival (OS).ResultsA total of 750 metachronous mCRC patients were identified. In all, 56% relapsed ≤2 years, 32.4% at 2-5 years and 11.6% >5 years. Median survival time from the time of diagnosis of mCRC for the three groups was 17.6, 26.1 and 27.5 months, respectively. Short TTR (5 years vs ConclusionTTR within 2 years is an independent predictor of shorter survival time for mCRC patients who experience a relapse. These data do not support the hypothesis that patients who have late relapse late (>5 years) have a 'better' biology or survival compared with patients with a TTR of 2-5 years.V T Broadbridge, C S Karapetis, C Beeke, R J Woodman, R Padbury, G Maddern, S W Kim, D Roder, P Hakendorf and T J Pric

Assessment of sleep-related disorders in children with sickle cell disease

Sleep-related disorders (SRDs) are common in sickle cell disease, however, identification may be time-consuming. Simultaneous survey of multiple SRDs utilizing a simplified instrument would facilitate screening. A simplified questionnaire investigating SRDs [sleep-disordered breathing (SDB), restless legs syndrome (RLS), insomnia, parasomnias, and daytime effects of disrupted sleep] was administered to 2-18-year-old children with sickle cell disease. One hundred participants completed this 5-7 minute survey without difficulties: 54 awoke unrefreshed, 41 had short-term insomnia, 30 had sleep-maintenance insomnia, 21 had chronic sleep-onset insomnia, 54 had chronic habitual snoring and 11 met the criteria for RLS. Sleep-maintenance insomnia was associated with increased body mass index (BMI) (p = 0.001), and chronic sleep-onset insomnia was associated with higher hemoglobin (Hb) levels (p = 0.04). Survey-reported symptoms of SRDs were significantly higher than that reported in the general pediatric population. A fast and simplified SRD survey is feasible and suggests a high prevalence of SRDs in children with sickle cell disease