19 research outputs found
Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy
IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical
attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced
colorectal cancers at diagnosis.
OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced
oncologic stage and change in clinical presentation for patients with colorectal cancer.
DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all
17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December
31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period),
in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was
30 days from surgery.
EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery,
palliative procedures, and atypical or segmental resections.
MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer
at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as
cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding,
lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery,
and palliative surgery. The independent association between the pandemic period and the outcomes
was assessed using multivariate random-effects logistic regression, with hospital as the cluster
variable.
RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years)
underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142
(56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was
significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR],
1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic
lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03).
CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the
SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients
undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for
these patients
Treatment of congestive heart failure with oral enoximone.
Treatment of congestive heart failure with oral enoximone
LAPAROSCOPIC APPENDECTOMY FOR ACUTE APPENDICITIS: WHAT SPACE IS THERE FOR TRAINING RESIDENTS?
Introduction:
Material and methods: We performed a retrospective study examining
the records of patients with acute appendicitis that underwent
laparoscopy appendectomy at our institution from September 2011 to
June 2017. Cases were divided in two groups: those performed by a
trainee (G1) and those performed by the senior surgeon (G2). In each
group we compared preoperative characteristics, operative data and
postoperative morbidity and mortality.Results: During the study period, 922 patients with clinical diagnosis
of appendicitis underwent laparoscopic appendectomy at our institution:
of these, 386 cases were performed primarily by residents and
536 were performed by senior surgeons. There were no statistical
differences in pre-operative characteristics of patients. The two
groups did not differ significantly regarding operative times (G1:67 \ub1
19 vs G2:70 \ub1 26 minutes), postoperative major complications
(G1:9% vs G2:19%), length of stay (3 \ub1 2 days for both groups), and
30-days mortality (none)., operative times (67 \ub1 19 vs 70 \ub1 26 min;
respectively), major complications (2% vs 3%; respectively) and
length of hospital stay (3 \ub1 2 vs 3 \ub1 3). Multivariate analysis confirmed
that the type of main surgeon was not an independent risk
factor for postoperative morbidity.
Conclusion: Postoperative results of laparoscopic appendectomies do
not differ significantly if surgeries are performed by residents as
opposed to specialists. Appendectomy can provide teaching opportunities
without compromising results for patients.
References:
Disclosure: No significant relationships
P13.22 * CYBERKNIFE STEREOTACTIC RADIOSURGERY FOR THE RE-IRRADIATION OF BRAIN LESIONS: A SINGLE-CENTRE EXPERIENCE
Adjuvant radiotherapy for a prostate cancer after renal transplantation and review of the literature
Renal transplant recipients are a population usually considered at a higher risk of malignancies, mostly skin cancer and lymphoproliferative disorder. In recent years, prostate cancer in renal transplant recipients has been becoming more frequent. This is probably due to the growing age and the longer survival of the transplanted patients. We report the case of a 50-year-old man with prostate cancer and renal allograft, who received radiotherapy after prostatectomy at the Institute of Radiotherapy of the University of Florence. Radiotherapy is part of the standard treatment for many cases of prostate cancer. According to the few series reported in the literature and also to our experience, radiation therapy is feasible also in renal transplant recipients with accurate treatment planning
Adjuvant Radiotherapy for a Prostate Cancer After Renal Transplantation and Review of the Literature
Radiotherapy and temozolomide in anaplastic astrocytoma: a retrospective multicenter study by the Central nervous system study group of AIRO (Italian association of radiation oncology).
Although the evidence for the benefit of adding temozolomide (TMZ) to
radiotherapy (RT) is limited to glioblastoma patients, there is currently a trend
toward treating anaplastic astrocytomas (AAs) with combined RT + TMZ. The aim of
the present study was to describe the patterns of care of patients affected by AA
and, particularly, to compare the outcome of patients treated exclusively with RT
with those treated with RT + TMZ. Data of 295 newly diagnosed AAs treated with
postoperative RT ± TMZ in the period from 2002 to 2007 were reviewed. More than
75% of patients underwent a surgical removal. All the patients had postoperative
RT; 86.1% of them were treated with 3D-conformal RT (3D-CRT). Sixty-seven percent
of the entire group received postoperative chemotherapy with TMZ (n = 198).
One-hundred sixty-six patients received both concomitant and sequential TMZ.
Prescription of postoperative TMZ increased in the most recent period
(2005-2007). One- and 4-year survival rates were 70.2% and 28.6%, respectively.
No statistically significant improvement in survival was observed with the
addition of TMZ to RT (P = .59). Multivariate analysis showed the statistical
significance of age, presence of seizures, Recursive Partitioning Analysis
classes I-III, extent of surgical removal, and 3D-CRT. Changes in the care of AA
over the past years are documented. Currently there is not evidence to justify
the addition of TMZ to postoperative RT for patients with newly diagnosed AA
outside a clinical trial. Results of prospective and randomized trials are
needed