Overall survival after resection for colon cancer in a national cohort study was adversely affected by TNM stage, lymph node ratio, gender, and old age

Background A national surveillance program of colon cancer treatment was introduced in 2007. We examined prognostic factors for colon cancer operated in 2000 with an aim of improving survival in the new program and a special focus on the merit of lymph node yield. Methods A cohort of 269 patients, 152 women (56.5%), with a mean age of 71 years, was operated for colon cancer in 2000 at three teaching hospitals and followed up for 7 years. Results Overall 5-year survival was 58.0%, and overall hospital mortality was 5.2%, with 4.5% in elective cases and 12.5% after urgent surgery. In only 41.1% of the specimens were 12 or more lymph nodes retrieved, but this did not affect survival in the combined cohort, although one of the hospitals achieved a significantly better result with a harvest of 12 or more lymph nodes. In a multivariate analysis, old age, gender, a high lymph node ratio (LNR) at stage III, and tumor–node–metastasis stage were adverse factors for survival. Conclusions The operative mortality was high and should be reassessed. The lymph node count did not have a significant impact on outcome overall, whereas the LNR proved significant for stage III. A prospective protocol using overall lymph node yield as a surrogate measure for more radical surgery, nevertheless, seems warranted to improve the lymph node harvest according to international recommendations

Results after 562 total elbow replacements: A report from the Norwegian Arthroplasty Register

Background: The aim of this study was to give results of elbow arthroplasty for a relatively large population and compare different prosthesis brands and different patient subgroups. Methods: Between 1994 and 2006, 562 total elbow replacement operations were reported to the Norwegian Arthroplasty Register. Revisions of prostheses were shown using Kaplan-Meier failure curves, and risk of revision was calculated using Cox regression analysis. Results: The overall 5-and 10-year failure rates were 8% and 15%, respectively. There were only minor differences between the different implants. Patients who developed traumatic arthritis after fracture had the worst prognosis compared with inflammatory arthritis (P ¼ .005). Risk of revision was also increased when the ulnar component was inserted without cement (P ¼ .02.) Conclusions: Good results in terms of prosthesis survival were obtained with total elbow arthroplasty, although results were worse than for knee-and hip arthroplasties. The best results were achieved in patients with inflammatory arthritis. Level of evidence: Level 2; prospective cohort study

Risk factors for revision after shoulder arthroplasty: 1,825 shoulder arthroplasties from the Norwegian Arthroplasty Register

Background and purpose Previous studies on shoulder arthroplasty have usually described small patient populations, and few articles have addressed the survival of shoulder implants. We describe the results of shoulder replacement in the Norwegian population (of 4.7 million) during a 12-year period. Trends in the use of shoulder arthroplasty during the study period were also investigated

Improved survival for anatomic total shoulder prostheses: Results of 4,173 shoulder arthroplasties reported to the Norwegian Arthroplasty Register from 1994 through 2012

Background and purpose — Previously, implant survival of total shoulder prostheses was reported to be inferior to that of hemiprostheses. However, the use of total prostheses has increased in Norway due to reported good functional results. On this background, we wanted to study implant survival of 4 major shoulder prosthesis types in Norway between 1994 and 2012. Patients and methods — The study population comprised 4,173 patients with shoulder replacements reported to the Norwegian Arthroplasty Register, including 2,447 hemiprostheses (HPs), 444 anatomic total prostheses (ATPs), 454 resurfacing prostheses (RPs), and 828 reversed total prostheses (RTPs). Three time periods were compared: 1994–1999, 2000–2005, and 2006–2012. Kaplan-Meier failure curves were used to compare implant failure rates for subgroups of patients, and adjusted risks of revision were calculated using Cox regression analysis. Results — For prostheses inserted from 2006 through 2012, the 5-year survival rates were 95% for HPs (as opposed to 94% in 1994–1999), 95% for ATPs (75% in 1994–1999), 87% for RPs (96% in 1994–1999), and 93% for RTPs (91% in 1994–1999). During the study period, the implant survival improved significantly for ATPs (p < 0.001). A tendency of better results with acute fracture and worse results in sequelae after previous fractures was seen in all time periods. Interpretation — The 5-year implant survival rates were good with all prosthesis types, and markedly improved for anatomic total prostheses in the last 2 study periods. The better functional results with total shoulder prostheses than with hemiprostheses support the trend towards increased use of total shoulder prostheses

A review of national shoulder and elbow joint replacement registries

The aim was to review the funding, organization, data handling, outcome measurements, and findings from existing national shoulder and elbow joint replacement registries; to consider the possibility of pooling data between registries; and to consider wether a pan european registry might be feasible