Results of rectal cancer treatment

Background: In Slovenia the incidence of colorectal cancer is growing rapidly. In 2000 591 new cases of colon cancer and 503 new cases of rectal cancer were registered. Our study compares results of two groups of patients with rectal cancer.Methods: In the period from January 1, 1991, to December 31, 2000, 528 patients with rectal carcinoma underwent resection. We divided them in two groups, one operated in the first 5-year and the other in later 5-year period. 5-year survival was estimated by means of Kaplan-Meier statistical analysis. Patients who died within 30 days after the operation were censored. Differences in survival curves between both groups were assessed by the log rank test.Results: We resected 528/591 (90.6 %) patients. R0 resection was performed in 431 (81.6 %) patients, R1 in 13 (2.5 %), and R2 in 84 (15.9 %) patients. Postoperative mortality rate in resected patients was 3.6 % (19/528), in the group with paliative operations was 12.7 % (7/55). Overall five-year survival rate was 52.4 % for rectal cancer. Five-year survival rate for the patients with radical resection (R0) was 59.5 %.Conclusions: 5-year survival for R0-resected patients with rectal cancer was in the period from 1996 to 2000 statistically significantly better compared with the period from 1991 to 1995 (63 % vs. 55 %) (p = 0.03627) in stage III (p = 0.01663).</p

Significance of Genetic Abnormalities of p53 Protein in Slovenian Patients with Gastric Carcinoma

Aim: To analyze genetic alterations of p53 gene in Slovenian gastric cancer patients and to compare these alterations with clinicopathological parameters in order to assess the value of p53 as a prognostic factor. Methods: We analyzed the samples from 230 Slovenian patients with gastric cancer, collected between 1983 and 2001. p53 expression was evaluated immunohistochemically with DO-7 monoclonal antibody. In addition, loss of heterozigosity (LOH) and microsatellite instability (MSI) of p53 gene were evaluated, as well as its mutational status in the selected population of patients. Results: p53 expression was associated with poorer survival and it was an independent predictor in multivariate analysis, along with TNM (T – size of tumor, N – nodal involvement, M – distant metastasis) stage status. Loss of heterozigosity and microsatellite instability status did not influence survival, however we found association of loss of heterozigosity with Lauren’s (Mantel-Haenszel test, P = .004) and Ming’s (Mantel-Haenszel test, P<.001) classification, whereas microsatellite instability was associated with gender (Mantel-Haenszel test, P = .017), TNM stage (χ2 test, P = .006) of gastric cancer, and lymph node involvement (pN) (χ2 test, P = .004). Conclusions: The data on p53 abnormalities, when considered separately, could be of relative value for predicting the behavior of gastric tumors. However, our analyses showed that studying p53 overexpression, loss of heterozigosity, microsatellite instability, and mutational analysis could provide data that, particularly in combination with some clinicopathological features, might be of clinical value for predicting the tumor behavior and patient response to therapy

Fluorescence-based bowel anastomosis perfusion evaluation: results from the IHU-IRCAD-EAES EURO-FIGS registry

Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Near-infrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry