Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most

Avances en la simulacion numerica de lubricacion hidrodinamica y el desino de superficies optimas

International audienc

THe impact of the cavitation model in the analysis of microtextured lubricated journal bearings

International audienc

Towards a single-phase mixed formulation of refractory castables and structural concrete at high temperatures

International audienceStructural materials are broadly used in applications such as nuclear vessels, high-temperature processes, and civil construction. Usually, during their placing and lifespan, they may present free or chemically bonded liquid phases in their structure, demanding careful attention when exposed to high heating rates. Their behavior in such conditions is a challenging problem as it comprises numerous highly nonlinear properties (not easily measured via experimental tests), strongly coupled equations and unreliable experimental benchmarks. Nonetheless, such simulations are of great interest. This work aims to provide a numerical study, checking whether its solution indeed converges and yields reliable results. Additionally, as the model needs several input parameters, this work conducts a sensitivity analysis and also assesses its applicability to more complex scenarios, as such issues remain open in the literature. In order to do that, a simple model that can be easily adapted for mixed formulations and complex geometries was proposed. It was found out that when considering unidimensional models the choices regarding the interpolation of the sorption isotherms are not essential to the numerical stability of the system. Besides that, the permeability and thermal conductivity of the material are the most important parameters that affect the simulation results of pressure, temperature and evaporable water content profiles. Finally, the 2D mesoscale simulation of concrete with polymeric fibers (based on the mixed formulation of the problem) yielded results that agreed with experimental observations. Thus, the model proposed herein can provide a solid base for future works and also important insights towards simpler methodologies

On the application of two-fluid flows solver to the casting problem

This book presents and discusses mathematical models, numerical methods and computational techniques used for solving coupled problems in science and engineering. It takes a step forward in the formulation and solution of real-life problems with a multidisciplinary vision, accounting for all of the complex couplings involved in the physical description. Simulation of multifaceted physics problems is a common task in applied research and industry. Often a suitable solver is built by connecting together several single-aspect solvers into a network. In this book, research in various fields was selected for consideration: adaptive methodology for multi-physics solvers, multi-physics phenomena and coupled-field solutions, leading to computationally intensive structural analysis. The strategies which are used to keep these problems computationally affordable are of special interest, and make this an essential book.Peer ReviewedPostprint (published version