The cancer patients’ quality of life

В статье приводится эмпирическое исследование качества жизни онкологических пациентов, перенесших оперативное вмешательство с формированием кишечной стомы. В исследовании приняли участие 311 человек в возрасте от 32 до 63 лет, тестированные с помощью методики SF -36. В результате исследования сделаны следующие выводы. У лиц, страдающих онкопатологией, перенесших оперативное вмешательство с формированием кишечной стомы, выявлены признаки снижения общего качества жизни. Показатели физического компонента здоровья онкологических пациентов достигают низких значений по всем составляющим: ролевое функционирование, обусловленное физическим состоянием; интенсивность боли; общее состояние здоровья. Шкалы, определяющие психический компонент здоровья пациентов, позволяют констатировать, что онкопатология оказывает негативное влияние на психоэмоциональное состояние больного: наличие депрессивных, тревожных тенденций, нарушение социального функционирования, жизненной активности и общее психологическое неблагополучие.This article provides an empirical study on the cancer patients’ quality of life undergoing surgery with the formation of intestinal stoma. The study involved 311 people aged from 32 to 63 years tested using the method of SF -36. The study reached the following conclusions. Individuals suffering from cancer pathology undergoing surgery with the formation of intestinal stoma, showed signs of lowering the overall quality of life. Indicators of physical health component of cancer patients reach low values in all components: role functioning due to physical condition, the intensity of pain, and general health. Scale defining mental health component of patients lead to the conclusion that cancer has a negative impact on the emotional state of the patient: the presence of depressive, anxiety tendencies, impaired social functioning, vitality and general psychological disadvantage

Использование рационально - эмотивной терапии при организации медико - психологического сопровождения онкобольных на амбулаторном этапе лечения

Метою даної роботи була організація комплексного медико-психологічного супроводу онкохворого, який переніс оперативне втручання з формуванням кишкової стоми на амбулаторному етапі лікування, з використанням елементів раціонально-емотивної психотерапії, та перевірка її ефективності. Використовували метод трансформації ірраціональних настанов в раціональні, з метою вироблення навичок позитивного мислення та адаптивної поведінки. Проведення заходів комплексного мультидисциплінарного медикопсихологічного супроводу онкохворих, які перенесли оперативне втручання з формуванням кишкової стоми, на амбулаторному етапі лікування, з включенням елементів раціонально-емотивної терапії, дозволяє значно покращити якість життя пацієнтів, поновити їх соціальні зв’язки, адаптивне функціонування та значно покращити психоемоційний стан 89,18 % досліджених.The aim of this work was to organize a complex medical and psychological support for cancer patients who underwent surgery with the formation of intestinal stoma in outpatient treatment, using elements of rationalemotive therapy, and test its effectiveness. The method of transformation irrational rational guidelines in order to develop positive thinking skills and adaptive behavior. Measures comprehensive multidisciplinary medical and psychological support for cancer patients who postpone surgery with intestinal stoma formation on outpatient treatment, with the inclusion of elements of rational-emotive therapy can significantly improve the quality of life of patients renew their social ties and adaptive functioning and well improve the psycho-emotional state of 89,18 % studied persons.Целью данной работы была организация комплексного медико-психологического сопровождения онкобольного, который перенес оперативное вмешательство с формированием кишечной стомы на амбулаторном этапе лечения, с использованием элементов рационально-эмотивной психотерапии, и проверка ее эффективности. Использовали метод трансформации иррациональных установок в рациональные, с целью выработки навыков позитивного мышления и адаптивного поведения. Проведение мероприятий комплексного мультидисциплинарного медико- психологического сопровождения онкобольных, которые перенесли оперативное вмешательство с формированием кишечной стомы, на амбулаторном этапе лечения, с включением элементов рационально-эмотивной терапии, позволяет значительно улучшить качество жизни пациентов, восстановить их социальные связи, адаптивное функционирование и значительно улучшить психоэмоциональное состояние 89,18 % обследованных

Evaluation advanced lymph node dissection impact on long-term survival rate of gastric cancer patients. Journal of Education

Over a period of 2007-2011 188 stomach cancer (SC) patients have been included in the research in abdominal oncosurgical department of Odessa regional oncological dispensary. It was retrospective, one-center, nonrandomized research. Volume of lymph node dissections differed by quantity of lymph nodes to be removed. All patients were divided into three groups. Patients with D1 or D1+ lymph node dissections have been performed, totally 90 patients are included in group of historical control. The main group includes 33 patients to whom D3 lymph node dissections is executed and, finally, control group – 65 patients dissected up to the D2 volume. In all cases so-called lymph node dissections for principal reasons have been executed. The multifactorial analysis of patients survival is implemented depending on a type of a lymph node dissections, a stage of the cancer, number of involved lymph nodes, involvement of the tumoral microcirculatory net (ly is carried out, v) signs of a perinevral invasion (Nev), availability of residual tumoral tissue (R), degree of a differentiation (G). Regardless of a disease stage, SC at 60% of patients, represented with initially hematologicaly disseminated disease. 40% of SC`s had no signs of intratumoral microcirculatory net involvement even in case of more than 15 regional lymph nodes are involved. In the absence of a SC perinevral invasion appeared to be the most precise predictive marker. The conclusion is made some brand new additional53 prognostic factors could play a crucial role in more accurate patients selection for expanded lymph node dissections

Comparison of survival rates made by the 6-th and 7-th editions of TNM classification in stomach cancer patients

The available classifications of malignant tumors reflect various aspects of their growth and some biological features. The most commonly used in Ukraine is the 6-th revision of TNM classification, which differs from the previous classifications of the section "Gastric cancer", mainly staging of category N, reflecting the presence of metastases in regional lymph nodes. Transition to the 7-th classification of TNM translates a part of patients from one stage to another, there is a so-called "stage migration" phenomenon. The famous mathematical phenomenon of Will Rogers describes this transition and theoretically substantiates its objectivity. The authors tracked the migration of patients and the change in the stage mainly from the point of view of the effect of this event on the survival of patients with stomach cancer

Analysis of survival after radical surgery for stomach cancer in odessa regional cancer center

The survival of patients with the locally advanced stage of stomach cancer (SC), who underwent various variants of preventive lymphatic nodes dissection, was considered. The survival of patients was compared with the stage and T, N indexes. Lymphadenectomy D2 were effective and increased cumulative survival in patient`s group T4aNoMo, stage IIB and T4aN1Mo, stage III A, and in groups of patients where D2 lymphadenectomy were ineffective - T4bNoMo, stage ІІІB, T4bN1Мo, stage ІІІB and T4aN2Мo, stage IIIB. D2 were more efficient operation in the case of tumor serosa invasion and invasion to the peritoneal cavity (SE) in the absence of multiple metastases to the regional lymph nodes (N1 according to the 7th revision of the classification - 1-2 metastatic lymph nodes), and when the tumor infiltrated the surrounding organs (SI) and the presence of multiple regional metastases, D2 lymphodissection did not gave positive results, comparising with D1

Novel data according Will Roger`s phenomenon in stomach cancer patients

Mostly Will Roger`s phenomenon means existence of so-called "jumping" or "jumping over the stages" regional metastases in the stomach cancer patients. N1 in the 6th edition means 16 regional lymph nodes involvement, while the N1 seventh edition – only 1-2 of regional lymph nodes involvement. This means that T1N1Mo \ 6th and T1N1Mo \ 7th - not quite the same, and the survival of the two groups will be different. The study, made on the abdominal oncosurgical department of Odessa Regional Oncology Center, included 188 patients operated for gastric cancer in the period 2007-2011. The study included only radically treated patients. Comparison of survival in patients with gastric cancer between 6th revision groups of 7th has been reviewed. The classification mission is to provide differences in the survival rates between the groups. Regression multivariate Cox analysis showed that 7th UICC classification showed different capability of stratifying survival groups of UICC N classification (P \ 0.01)

The original formula for predicting the survival of gastric cancer patients undergoing surgical treatment

The purpose of this work was to find ways to predict the survival of gastric cancer patients. The study included 221 patients who were radically operated in the abdominal department of the Odessa Regional Oncology Center from 2007 to 2013. The life expectancy of this group of patients was measured in months. From the factors given in the article, only the age of the patient, the presence and invasion in neighboring organs and the number of organs resected during the operation were those factors that had a significant impact on the prognosis. A formula was obtained for the formal evaluation of the duration of patients. The results are preliminary. Conclusions. As a result of the regression analysis, a polynomial (formula) was obtained, which can be used to predict the survival of patients who underwent surgery for gastric cancer. There is a need to create clearer gradations of survival dependencies of cancer patients from different clinical and morphological situations. A mathematical apparatus with many variables can be used to create similar models for the analysis of survival in other types of pathology

Lymph node dissection impact on long-term survival rate of gastric cancer patients in Ukraine

Over a period of 2007-2011 188 stomach cancer (SC) patients have been included in the research in abdominal oncosurgical department of Odessa oncological center. Volume of lymph node dissections differed by quantity of lymph nodes to be removed. All patients were divided into three groups. Patients with D1 or D1+ lymph node dissections have been performed, totally 90 patients are included in group of historical control. In all cases so-called lymph node dissections for principal reasons have been executed. The multifactorial analysis of patients survival is implemented depending on a type of a lymph node dissections, a stage of the cancer, number of involved lymph nodes, involvement of the tumoral microcirculatory net (ly is carried out, v) signs of a perinevral invasion (Nev), availability of residual tumoral tissue (R), degree of a differentiation (G). Regardless of a disease stage, SC at 60 % of patients, represented with initially hematologicaly disseminated disease. 40 % of SC`s had no signs of intratumoral microcirculatory net involvement even in case of more than 15 regional lymph nodes are involved

Analysis of patients’ survival after radical surgery for gastric cancer

Рассмотрена выживаемость больных с местно-распространенными стадиями рака желудка (РЖ), которым были выполнены различные варианты лимфатических диссекций. Сравнивалась выживаемость больных в зависимости от категорий T и N (TNM-7). На основании критерия р выделены группы, где лимфодиссекции D2 были эффективны и увеличивали кумулятивную выживаемость больных: T4aN0М0 ІІВ, T4aN1М0 ІІІА, и группы больных, где D2 лимфодиссекции были неэффективны – T4bN0М0 ІІІB, T4bN1М0 ІІІB и T4aN2Мo ІІІB стадии. D2 операции эффективнее D1 операций при прорастании опухолью серозы (SE) до полости брюшины, а при прорастании опухоли в окружающие органы (SI) и/или наличии множественных регионарных метастазов (N2) D2 лимфодиссекции не дали больше положительных результатов, чем D1.We consider the survival of patients with locally advanced stage of gastric cancer (GC), whom the various options of preventive lymph nodes dissections were performed. We compare the survival rates of patients depending on the staging criteria T and N (TNM-7). On the basis of the criteria “p” groups, where D2 lymph nodes dissections were effective and cumulative survival rates were increased T4aN0M0 IIB, T4aN1M0 IIIA stages, and where D2 were ineffective in terms of survival – T4aN2M0, T4bN0M0 and T4bN1M0 (all IIIB stage) group. D2 are more effective than D1 operations in the case of SE – invasion serosa up to the peritoneal cavity, but when SI – infltration in the surrounding organs the D2 dissection did not give more positive results than D1

Experience in the implementation of palliative, combined and expanded operations in emergency surgery of gastric cancer

В статье рассмотрен опыт выполнения неотложных абдоминальных онкохирургических операций, выполненных на базе отделения абдоминальной онкологии за период 2012–2014 гг. Всего в исследование включен 51 больной, которым выполнены ургентные и срочные плановые операции по поводу осложнений рака желудка. Всего выполнено 27 паллиативных, 6 расширенных, 15 комбинированных операций. По-настоящему ургентных было только 2, во время которых были выполнены в обоих случаях гастрэктомии со спленэктомией без выполнения расширенных лимфодиссекций. Сделан вывод, что выполнение радикальных операций не увеличивает летальность при осложненном течении рака желудка. В мировой ургентной медицине используются различные классификации срочных, в т. ч. неотложных операций, наиболее унифицированной из которых является классификация WSES-2013. Традиционное, “отечественное” распределение неотложных онкологических операций на ургентные/срочные/плановые или даже чаще на ургентные/ плановые является устоявшимся и необходимым. Индивидуализация подхода к каждой ургентной операции, как и вообще тенденция к индивидуализации в онкологии, представляется неотъемлемым мотивом грядущих методологических перемен в неотложной онкохирургии.The article describes the experience of urgent oncosurgical abdominal operations carried out on the basis of Abdominal Oncology Department for the period 2012–2014 years. In total, the study included 51 patients, who underwent emergent and urgent elective surgery for complications of stomach cancer. Total holds 27 palliative, 6 advanced, 15 combined operations. The really emergent were only 2, during which were performed in both cases gastrectomy with splenectomy without performing extended lymph node dissection. It was concluded that the implementation of radical surgery does not increase mortality rate in complicated gastric cancer. In the world of emergent medicine there are used different classification approaches, including emergency operations, most of which is a unified classification WSES-2013. The traditional distribution of urgent cancer operations in urgent / emergency / routine or even more frequently in the urgent / routine is well established and necessary. Personalisation approach to each of urgent surgical case, as well as general trend towards individualization in oncology seems to be inherent motive of future methodological changes in emergency cancer surgery