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Anastomotic leakage following routine mesorectal excision for rectal cancer in a national cohort of patients.

https://arctichealth.org/en/permalink/ahliterature17308
Source
Colorectal Dis. 2005 Jan;7(1):51-7
Publication Type
Article
Date
Jan-2005
Author
M T Eriksen
A. Wibe
J. Norstein
J. Haffner
J N Wiig
Author Affiliation
Department of Surgery, Buskerud Hospital, Drammen, Norway. mteriksen@start.no
Source
Colorectal Dis. 2005 Jan;7(1):51-7
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Adolescent
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical - adverse effects
Carcinoma in Situ - mortality - pathology - surgery
Colon - surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Norway
Prospective Studies
Rectal Neoplasms - mortality - pathology - surgery
Rectum - surgery
Research Support, Non-U.S. Gov't
Risk factors
Abstract
OBJECTIVE: Mesorectal excision is successfully implemented as the standard surgical technique for rectal cancer resections in Norway. This technique has been associated with higher rates of anastomotic leakage (AL) and the purpose of this study was to examine AL in a large national cohort of patients. METHODS: This was a prospective national cohort study of 1958 patients undergoing rectal cancer surgery with anterior resection in Norway from November 1993 to December 1999. RESULTS: The overall rate of AL was 11.6% (228 of 1958 patients). In a multivariate analysis, the risk of AL was significantly higher in males (odds ratio (OR) 1.6, 95% confidence interval (CI) 1.1-2.2), in patients receiving pre-operative radiotherapy (OR 2.2, CI 1.0-4.7) and in low level (4-6 cm) (OR 3.5, CI 1.6-7.7) and ultra-low level (
PubMed ID
15606585 View in PubMed
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Changing pattern of histological type, location, stage and outcome of surgical treatment of gastric carcinoma.

https://arctichealth.org/en/permalink/ahliterature20474
Source
Br J Surg. 2000 May;87(5):618-26
Publication Type
Article
Date
May-2000
Author
K. Borch
B. Jönsson
E. Tarpila
T. Franzén
J. Berglund
E. Kullman
L. Franzén
Author Affiliation
Department of Surgery, University Hospital of Linköping and Department of Pathology, Orebro Medical Centre Hospital, Sweden.
Source
Br J Surg. 2000 May;87(5):618-26
Date
May-2000
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Adult
Age Distribution
Aged
Aged, 80 and over
Female
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Prognosis
Proportional Hazards Models
Research Support, Non-U.S. Gov't
Sex Distribution
Stomach Neoplasms - mortality - pathology - surgery
Survival Rate
Sweden - epidemiology
Abstract
BACKGROUND: There are indications that some features of gastric carcinoma are changing, with a possible impact on prognosis. The aim of this study was to examine any changes in type, location, stage, resection rate, postoperative mortality rate or prognosis for patients with gastric carcinoma in a well defined population. METHODS: During 1974-1991, 1161 new cases of gastric adenocarcinoma were diagnosed in Ostergötland County, Sweden. Tumour location, Laurén histological type, tumour node metastasis (TNM) stage, radicality of tumour resection and postoperative complications were recorded after histological re-evaluation of tissue specimens and examination of all patient records. Dates of death were obtained from the Swedish Central Bureau of Statistics. Time trends were studied by comparing the intervals 1974-1982 (period 1) and 1983-1991 (period 2). RESULTS: The proportion of diffuse type of adenocarcinoma increased (from 27 to 35 per cent), while that of mixed type decreased (from 16 to 9 per cent) and that of intestinal type was unchanged. The proportion of tumours located in the proximal two-thirds of the stomach increased (from 32 to 42 per cent) and the proportion of patients with tumours in TNM stage IV decreased (from 32 to 25 per cent). Overall tumour resection rates were unchanged, although the proportion of radical total gastrectomies increased (from 36 to 50 per cent). Excluding tumours of the cardia or gastric remnant after previous ulcer surgery, the 5-year relative survival rate after radical resection increased from 25 to 36 per cent and the postoperative mortality rate decreased for both radical (from 11 to 4 per cent) and palliative (from 18 to 6 per cent) resection. CONCLUSION: The patterns of tumour histology, location and stage of gastric carcinoma have changed in the authors' region. These changes were paralleled by a significant improvement in survival and postoperative mortality rates.
PubMed ID
10792320 View in PubMed
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Clinical outcome after D1 vs D2-3 gastrectomy for treatment of gastric cancer.

https://arctichealth.org/en/permalink/ahliterature163915
Source
Scand J Surg. 2007;96(1):35-40
Publication Type
Article
Date
2007
Author
H. Danielson
A. Kokkola
T. Kiviluoto
J. Sirén
J. Louhimo
E. Kivilaakso
P. Puolakkainen
Author Affiliation
Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Source
Scand J Surg. 2007;96(1):35-40
Date
2007
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Adult
Aged
Aged, 80 and over
Female
Finland - epidemiology
Follow-Up Studies
Gastrectomy - methods
Hospital Mortality - trends
Humans
Lymph Node Excision - methods
Male
Middle Aged
Postoperative Complications - epidemiology
Prevalence
Retrospective Studies
Stomach Neoplasms - mortality - pathology - surgery
Survival Rate - trends
Treatment Outcome
Abstract
Clinical benefit from extended lymphadenectomy for gastric cancer remains controversial as a considerable variation exists between results of different studies.
562 patients were treated at HUCH between 1987-2003, whereof 223 underwent gastrectomy with curative intent. Of these, 114 patients underwent subtotal/total gastrectomy with D1 (standard) lymphadenectomy and 109 patients had D2-3 (extended) lymph node dissection. The clinical outcome of these patients was analysed retrospectively.
The incidence of surgical complications was 33.0% in D2-3 and 16.8% in D1 lymphadenectomy groups (p = 0.008). Abscess was the most common complication (11.0%) among D2-3 operated patients and haemorrhage (4.4%) in D1 group. Hospital mortality was 3.7% in D2-3 and 1.8% in D1 group (p = 0.438). The only statistically significant factor influencing the rate of complications was D2-3 lymphadenectomy (OR 2.620, 95% C.I. 1.375 to 4.991). D2-3 was associated with a longer postoperative hospital stay and operation time, greater blood loss and increased need for blood transfusions compared to D1. The 5-year survival was not statistically different between lymphadenectomy groups.
It is justified to perform a D2-3 gastrectomy in Europe with a acceptable postoperative mortality but with a significant morbidity. Further studies are needed to assess the value of extended lymphadenectomy in gastric cancer.
PubMed ID
17461310 View in PubMed
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[Early complications after surgery for middle- and lower-ampullar cancer: total mesorectumectomy or "blind" preparation of rectum?].

https://arctichealth.org/en/permalink/ahliterature262646
Source
Khirurgiia (Mosk). 2014;(11):26-33
Publication Type
Article
Date
2014
Author
V V Polovinkin
V A Porkhanov
P V Tsar'kov
I A Tulina
A V Volkov
A A Khalafian
Source
Khirurgiia (Mosk). 2014;(11):26-33
Date
2014
Language
Russian
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Blood Loss, Surgical - statistics & numerical data
Cohort Studies
Colectomy - adverse effects - methods
Comparative Effectiveness Research
Female
Humans
Male
Middle Aged
Organ Sparing Treatments - methods
Postoperative Complications - classification - diagnosis - epidemiology - prevention & control
Rectal Neoplasms - mortality - pathology - surgery
Rectum - pathology
Russia - epidemiology
Abstract
It was performed a comparative analysis of parameters of early postoperative period in 318 patients with middle- and lower-ampullar cancer of rectum who underwent total mesorectumectomy and "blind" preparation of rectum. All patients were divided into 2 groups. The main group included 202 patients after total mesorectumectomy. The control group included 116 patients after "blind" preparation of rectum. Statistically significant differences in frequency of laparotomy wounds suppuration, urinary tract dysfunction and postoperative mortality were revealed. These complications were diagnosed more frequent in case of "blind" preparation of rectum. In the main group laparotomy wounds suppuration depended on sex (p
PubMed ID
25589180 View in PubMed
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Early gastric cancer: clinical characteristics and results of surgery.

https://arctichealth.org/en/permalink/ahliterature147287
Source
Dig Surg. 2009;26(5):378-83
Publication Type
Article
Date
2009
Author
A. Nieminen
A. Kokkola
J. Ylä-Liedenpohja
J. Louhimo
H. Mustonen
P. Puolakkainen
Author Affiliation
Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Source
Dig Surg. 2009;26(5):378-83
Date
2009
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Adult
Aged
Aged, 80 and over
Female
Finland - epidemiology
Gastrectomy - adverse effects - methods - mortality
Humans
Male
Middle Aged
Prognosis
Stomach Neoplasms - mortality - pathology - surgery
Survival Analysis
Survival Rate
Time Factors
Treatment Outcome
Abstract
Early gastric cancer (EGC) is associated with better prognosis than advanced cancer of the stomach. Unfortunately, EGC accounts for a minority of operated gastric cancers in Europe. The aim of this study was to evaluate the clinical characteristics of EGC and the outcome after surgery.
The study group comprised 94 EGC patients having undergone surgery at Helsinki University Central Hospital between April 1983 and July 2007.
The overall 5-year survival rate of EGC patients was 92.4%. Tumor location in the upper part of the stomach and mixed histological type impaired the prognosis (p = 0.043 and 0.008, respectively). The probability of lymph node metastasis was significantly higher when the tumor infiltrated gastric submucosa rather than mucosa (p = 0.012). Existence of lymph node or distant metastases decreased the survival rates (both p
PubMed ID
19923825 View in PubMed
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The effect of wait times on oncological outcomes from periampullary adenocarcinomas.

https://arctichealth.org/en/permalink/ahliterature114318
Source
J Surg Oncol. 2013 Jun;107(8):853-8
Publication Type
Article
Date
Jun-2013
Author
Spencer R McLean
Divya Karsanji
Jennifer Wilson
Elijah Dixon
Francis R Sutherland
Janice Pasieka
Chad Ball
Oliver F Bathe
Author Affiliation
Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Source
J Surg Oncol. 2013 Jun;107(8):853-8
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Adult
Aged
Ampulla of Vater - pathology - surgery
Canada
Common Bile Duct Neoplasms - mortality - pathology - surgery
Female
Humans
Male
Middle Aged
Neoplasm Staging
Pancreatectomy
Pancreatic Neoplasms - mortality - pathology - surgery
Retrospective Studies
Survival Analysis
Time Factors
Treatment Outcome
Waiting Lists
Abstract
Overall few patients presenting with periampullary adenocarcinomas have resectable lesions. We postulated that rapid diagnosis and treatment would enhance the likelihood of successful resection, improving survival.
A retrospective analysis of patients undergoing surgery for resection of a pancreatic or periampullary lesion was conducted. Resection rate, disease stage and survival were evaluated as a function of wait times.
Pancreatic resections were booked in 355 patients. Of 193 patients with periampullary adenocarcinomas, 119 patients (61.7%) had resectable disease. There was no difference in median time from initial physician consultation to surgery in patients with resectable and unresectable disease (61 days vs. 64 days, respectively). The likelihood of successful resection was virtually identical in patients with wait times = 30 and > 30 days (from surgical consultation to procedure). There was a trend toward a higher T-stage in patients who waited >30 days for surgery (P = 0.055). However, there was no difference in survival as a function of wait time.
This series does not demonstrate an advantage for rapid diagnosis and surgery, in terms of resection rate and survival. However, further study is required in a larger cohort of patients, to confirm these findings.
PubMed ID
23625192 View in PubMed
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Gastric cancer: establishing predictors of biologic behavior with use of population-based data.

https://arctichealth.org/en/permalink/ahliterature180065
Source
Ann Surg Oncol. 2004 Jun;11(6):629-35
Publication Type
Article
Date
Jun-2004
Author
B J Dicken
L D Saunders
G S Jhangri
C. de Gara
C. Cass
S. Andrews
S M Hamilton
Author Affiliation
2D2 Walter C. Mackenzie Health Sciences Center, 8440-112 St. University of Alberta Hospital, Edmonton, Alberta, Canada T6G 2B7.
Source
Ann Surg Oncol. 2004 Jun;11(6):629-35
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Adult
Aged
Aged, 80 and over
Alberta - epidemiology
Disease-Free Survival
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Multivariate Analysis
Predictive value of tests
Prognosis
Proportional Hazards Models
Retrospective Studies
Stomach Neoplasms - mortality - pathology - surgery
Survival Rate
Abstract
Tumor thickness and nodal status are important predictors of survival following curative resection for gastric cancer. Lymphovascular invasion (LVI) is a potential predictor of biological behavior. The relationship between LVI and tumor thickness (T status) has not been established in population-based studies.
Clinicopathological and survival data of 577 patients at nine centers, from between 1991 and 1997, was collected from patient records and a Provincial Cancer Registry. The primary endpoint of the study was death. A secondary analysis of a node-negative subgroup examined the significance of LVI with respect to T status.
The population disease-specific survival was 28%. In a multivariate analysis, T, N, M, esophageal margin, tumor morphology, and residual tumor category were independent predictors of survival. LVI was documented in 58% of resected tumors. LVI correlated with advancing T and N status but was not significant in a multivariate population model. Subgroup analysis of node-negative gastric cancer found T status and LVI to be independent predictors of survival. LVI was associated with a 5-year survival of 8%, versus 43% among patients in whom it was absent (P
PubMed ID
15150070 View in PubMed
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Gastric cancer in Iceland. What is the current status? Survival of 193 patients operated on for cure, 1980-1995.

https://arctichealth.org/en/permalink/ahliterature20002
Source
Ann Chir Gynaecol. 2000;89(4):262-7
Publication Type
Article
Date
2000
Author
S. Gunnlaugsson
A. Smith
T. Gugbjartsson
M. Oddsdóttir
S S Datye
J. Hallgrímsson
J. Magnússon
Author Affiliation
Department of Surgery, Landspitalinn University Hospital, Reykjavik, Iceland.
Source
Ann Chir Gynaecol. 2000;89(4):262-7
Date
2000
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Adult
Aged
Aged, 80 and over
Female
Gastrectomy
Hospital Mortality
Humans
Iceland - epidemiology
Incidence
Male
Middle Aged
Neoplasm Staging
Prospective Studies
Stomach Neoplasms - mortality - pathology - surgery
Abstract
OBJECTIVE: The incidence of gastric cancer has been decreasing in the last decades. Nevertheless, gastric cancer is still a substantial health problem in Iceland. The aim of this study was to analyze the survival of patients with gastric cancer operated on for cure. MATERIAL AND METHODS: We reviewed all medical files for above-mentioned patients, operated on at the National University Hospital in Reykjavik and the Quarter District Hospital of Akureyri during 1980-1995. The study was divided into three periods: 1980-1985, 1986-1990 and 1991-1995. The five-year survival for each study period and for the whole group was evaluated. RESULTS: The study group included 193 patients between the ages of 21-96 (median 71). The five-year survival for the whole group was 28% (26% 1980-1985, 22% 1986-1990, 35% 1991-1995). Despite longer survival during the last period, it was not statistically significant (p = 0.16). The major survival factor of gastric cancer was the stage of the disease at diagnosis. A greater number of patients were at stage IA during 1991-1995. The complication rate was rather high or 31% and the hospital mortality was 6.7%. CONCLUSION: The survival of patients with gastric cancer operated on for cure was low in Iceland but comparable to that in other countries. During the last years, the survival has been rising, and fortunately, more were diagnosed at a lower stage of the disease. These operations have a considerable risk and the hospital mortality was substantial.
PubMed ID
11204955 View in PubMed
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Impact of hospital volume on long-term survival after esophageal cancer surgery.

https://arctichealth.org/en/permalink/ahliterature78730
Source
Arch Surg. 2007 Feb;142(2):113-7; discussion 118
Publication Type
Article
Date
Feb-2007
Author
Rouvelas Ioannis
Lindblad Mats
Zeng Wenyi
Viklund Pernilla
Ye Weimin
Lagergren Jesper
Author Affiliation
Unit of Esophageal and Gastric Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. ioannis.rouvelas@ki.se
Source
Arch Surg. 2007 Feb;142(2):113-7; discussion 118
Date
Feb-2007
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - pathology - surgery
Aged
Carcinoma, Squamous Cell - mortality - pathology - surgery
Esophageal Neoplasms - mortality - pathology - surgery
Esophagectomy
Female
Follow-Up Studies
Hospitals, University - statistics & numerical data
Humans
Male
Middle Aged
Population Surveillance
Postoperative Period
Retrospective Studies
Survival Rate - trends
Sweden - epidemiology
Treatment Outcome
Abstract
HYPOTHESIS: The improved survival after esophageal cancer surgery in Sweden during recent years may be attributable to the increased centralization of such surgery. DESIGN: Population-based study. SETTING: All Swedish residents undergoing esophageal cancer surgery from January 1, 1987, through December 31, 2000, were identified from the inpatient and cancer registers and were followed up until October 18, 2004, through nationwide registers. Hospital, tumor, and patient characteristics and preoperative oncological treatment were assessed through the registers and histopathological records. PATIENTS: Among 4904 patients with esophageal cancer, 1199 patients (24.4%) who underwent resection constituted the study cohort. Main Outcome Measure Survival rates and hazard ratios (HRs) relative to hospital volume. Low-volume hospitals (LVHs) conducted fewer than 10 esophagectomies annually, while high-volume hospitals (HVHs) conducted 10 or more. Hazard ratios were adjusted for several potential confounders. RESULTS: Thirty-day survival was 96% at HVHs and 91% at LVHs (P = .09). Survival rates 1, 3, and 5 years after surgery at HVHs were nonsignificantly higher (58%, 35%, and 27%, respectively) compared with those at LVHs (55%, 30%, and 24%, respectively). The adjusted HR was nonsignificantly 10% decreased at HVHs (HR, 0.90; 95% confidence interval, 0.79-1.04). In an analysis restricted to 764 patients (64%) without preoperative oncological treatment (in which the tumor stage was also adjusted for), survival was similar at HVHs and at LVHs (HR, 0.99; 95% confidence interval, 0.84-1.18). CONCLUSIONS: This study revealed no effect of hospital volume on long-term survival after esophageal cancer surgery. Tumor biology apparently has a greater effect on the chances of long-term survival than hospital volume.
PubMed ID
17309961 View in PubMed
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37 records – page 1 of 4.