The impact of age on post-operative outcomes of colorectal cancer patients undergoing surgical treatment

BACKGROUND: the purpose of study was to evaluate the impact of age on outcomes in colorectal cancer surgery. METHODS: patients on hospital database treated for colorectal cancer during the period 1995 – 2002 were divided into two groups: Group 1 – patients of 75 years or older (n = 154), and Group 2 – those younger than 75 years (n = 532). RESULTS: In Group 1, for colon cancers, proximal tumors were significantly more common (23% vs. 13.5%, p < 0.05), complicated cases were more frequent (46 % vs. 33%, p = 0.002), bowel obstruction more common at presentation (40% vs. 26.5%, p = 0.001), and more frequent emergency surgery required (24% vs. 14%, p = 0.003). Postoperative overall morbidity was higher in the elderly group, but with no differences in surgical complications rate. Overall 5 year survival was 39% vs. 55% (p = 0.0006) and cancer related 5 year survival was 44% vs. 62% (p = 0.0006). Multivariate Cox analysis showed that age was not an independent risk factor for postoperative mortality. CONCLUSION: Preoperative complications and co-morbidities, more advanced disease, and higher postoperative nonsurgical complication rates adversely affect postoperative outcomes after surgery for colorectal cancer in the elderly

Lymph node retrieval after resection of rectal cancer following preoperative chemoradiotherapy

Background. According to the current guidelines of proper TNM staging, 12 lymph nodes per specimen are crucial. This study assessed the role of preoperative radiochemotherapy on the number of lymph nodes detected in the tumor-bearing specimen. Material and methods. Retrospective data of 138 patients who underwent surgery for stage II and III rectal cancer without preoperative radiochemotherapy during the period of 2004–2006 (control group) were compared with prospective data of 38 patients who received preoperative radiochemotherapy during the period of 2007–2008 (study group). The number of patients with metastatic lymph nodes, number of lymph nodes per specimen, number of metastatic lymph nodes per specimen, and the size of the tumor between the groups were compared. Results. Positive lymph nodes were detected in 88 (64%) patients in the control group as compared with 9 (21%) patients in the study group (P&lt;0.05). The mean number of lymph nodes per specimen in the control group was 13.5, while in the study group, the mean number of lymph nodes per specimen was 6.29 (P&lt;0.05). There was a significant difference in the mean number of metastatic lymph nodes per specimen between the groups (5.12 in the control group versus 2.11 in the study group; P&lt;0.05). The mean size of the tumor was 4.37 cm in the control group and 2.45 cm in the study group (P&lt;0.01). Conclusions. Preoperative radiochemotherapy for advanced rectal cancer significantly decreased the number of lymph nodes detected in the tumor-bearing specimen. This also resulted in a significant decrease in the number of metastatic lymph nodes detected in the specimen, and fewer patients with stage III (N+) cancer were diagnosed. Preoperative radiochemotherapy could induce a significant downsizing and downstaging of advanced rectal cancer, but great care in operative and pathologic examination techniques must be taken to ensure appropriate staging

Survival of Patients With Testicular Cancer in Lithuania During 1999–2002

The aim of this study was to evaluate the survival of patients with testicular cancer in Lithuania during 1998–2002 and factors that influenced the survival.Material and methods. The survival rates of testicular cancer patients were evaluated using the data of the Lithuanian Cancer Registry for 1998–2002. The survival was evaluated using the Kaplan-Meier method and log-rank test in order to compare the survival rates. The observed survival rates were calculated.Results. The 5-year observed survival rate in Lithuania was 71.2% (95% CI, 64.4%–77.5%). The survival of testicular cancer patients depended on age at the time of diagnosis, histology of tumor, stage and extent of disease.Conclusions. The survival of patients with testicular cancer in Lithuania was substantially lower than in other European countries. The better survival was associated with younger age and lesser extent of metastases

Susirgusiųjų sėklidžių vėžiu 1998–2002 išgyvenamumas Lietuvoje

The aim of this study was to evaluate the survival of patients with testicular cancer in Lithuania during 1998–2002 and factors that influenced the survival. Material and methods. The survival rates of testicular cancer patients were evaluated using the data of the Lithuanian Cancer Registry for 1998–2002. The survival was evaluated using the Kaplan-Meier method and log-rank test in order to compare the survival rates. The observed survival rates were calculated. Results. The 5-year observed survival rate in Lithuania was 71.2% (95% CI, 64.4%–77.5%). The survival of testicular cancer patients depended on age at the time of diagnosis, histology of tumor, stage and extent of disease. Conclusions. The survival of patients with testicular cancer in Lithuania was substantially lower than in other European countries. The better survival was associated with younger age and lesser extent of metastases

Guidelines for diagnostics and treatment of aromatase inhibitor-induced bone loss in women with breast cancer : a consensus of Lithuanian medical oncologists, radiation oncologists, endocrinologists, and family medicine physicians

The aim of this article is to inform about cancer treatment-induced bone loss, to identify patients at risk and those that can benefit from bone targeted treatment as well as highlight the importance of the multidisciplinary approach in the bone health in cancer care. Patients with breast cancer treated or intended to be treated with aromatase inhibitors belong to a high-risk group because their fracture risk increases up to 30% due to a significant decrease in bone mineral density within 6–12 months after the start of hormonal treatment. To evaluate bone status and predict risk for fractures, lateral thoracic and lumbar spine X-ray imaging, bone mineral density measurement by dual energy X-ray absorptiometry at the lumbar spine L1–L4 vertebrae and/or hip and fracture risk factors assessment are mandatory tests prior to hormonal treatment. Morbidity and mortality associated with bone loss can be prevented with appropriate screening, lifestyle interventions, and therapy. Algorithm for the management of bone health in breast cancer patients was established in Lithuania to screen patients with increased risk for bone loss and to provide adequate specific osteoporosis treatment

Preoperative long-course chemoradiotherapy plus adjuvant chemotherapy versus short-course radiotherapy without adjuvant chemotherapy both with delayed surgery for stage II–III resectable rectal cancer: 5-Year survival data of a randomized controlled trial

Background and objective: At present, there are common recommendations for treatment for stage II–III resectable rectal cancer patients: preoperative conventional chemoradiotherapy (CRT) with delayed surgery in 6–8 weeks or preoperative short-course radiotherapy (SCRT) followed by immediate surgery. The aim of this study was to compare overall survival (OS) and disease-free survival (DFS) in two treatment groups: preoperative SCRT and CRT both with delayed surgery plus adjuvant chemotherapy in CRT arm. Materials and methods: A total of 150 patients were randomly assigned to two groups: 75 to CRT (preoperative conventional CRT, 50 Gy/25 fr with fluorouracil and leucovorin on the 1st and the 5th week of RT followed by TME surgery in 6–8 weeks and 4 cycles of adjuvant fluorouracil/leucovorin every 4 weeks; then follow-up) and 75 to SCRT (preoperative short-course RT, 25 Gy/5 fr followed by TME surgery in 6–8 weeks; then follow-up). The data of 140 patients (72 in CRT and 68 in SCRT group) were included in statistical analysis. Primary end points were OS and DFS. Results: Median follow-up was 60.5 (range, 5–108) months. The 5-year DFS was 67% in the CRT group (n = 72) and 45% in the SCRT group (n = 68) (P = 0.013; HR = 1.88; 95% CI, 1.13–3.12; P = 0.015). The 5-year OS was 79% and 62% in the CRT and SCRT groups, respectively (P = 0.015; HR = 2.05; 95% CI, 1.13–3.70; P = 0.017). The 5-year OS for intent-to-treat (ITT) population (n = 150) was 78% in the CRT and 58% in the SCRT group (P = 0.003; HR = 2.28; 95% CI, 1.30–4.00; P = 0.004). Conclusions: The 5-year DFS and OS were significantly better in the CRT than the SCRT group. For ITT population, OS was also significantly better after CRT versus SCRT