Background: There is no clear evidence on whether radiotherapy (RT) improves treatment result in patients with retroperitoneal sarcomas (RPS). Methods: A systematic literature search was performed using PubMed, Scopus and CENTRAL databases. Data were retrieved from published comparatives studies in patients with RPS undergoing surgery alone or RT plus surgery. The primary endpoints were the 5-year OS and the median OS. The secondary endpoints were the recurrence-free survival (RFS) and the R0-resection rate. Continuous outcomes were calculated by means of weighted mean difference (WMD). Results: Ten out of 374 articles were analyzed. The median OS and the 5-year survival were significantly increased in patients treated with RT and surgery, compared to patients treated with surgery alone ( p < 0.00001, p < 0.001). Median RFS was significantly increased in patients treated with either preoperative ( p < 0.001) or postoperative ( p = 0.001) RT compared to patients that underwent surgery alone. Finally, median R0-resection rate was similar between the two groups ( p = 0.56). Conclusion: RT along with radical surgery could be the standard of care in at least a subgroup of patients with RPS.
18 January 2020 in International Journal of Colorectal Disease
Background and Objectives: Hydatid disease (HD) remains a significant public health issue causing morbidity and mortality in many Mediterranean countries. Material and Methods: The present cohort study included 50 consecutive patients with liver hydatid disease who underwent surgery in a tertiary University Hospital. A total of 18 patients (36%) had a case of complicated HD, including simple communication of the cyst with the biliary tree (6 cases), rupture of the cyst into the biliary tree (6 cases), presence of a bronco-biliary fistula (2 cases), rupture of the cyst in the peritoneal cavity (2 cases), and rupture of the cyst and formation of a hepatic abscess (2 cases). Endoscopic retrograde cholangiopancreatography (ERCP) was pre-operatively performed on six patients. Results: The main clinical symptom presented was right upper quadrant pain in 16 patients (88%), which was associated with high fever (>39 °C) in 14 patients (78%). C-reactive protein (CRP) was the primary indicator of a complicated HD (p = 0.003); however, it was only elevated in 67% of cases. CRP was a more sensitive indicator of a rupture in the biliary tree cyst (p = 0.02). Computer tomography (CT) detected more cases (44%) of a complicated HD than ultrasonography (US) (25%); however, the difference was not statistically significant. Conclusions: For prevention and control of HD, a high suspicion of the disease leading to early referral to specialized centers, mainly in endemic areas, is required. Prior to surgical or percutaneous intervention, a combination of imaging and laboratory findings are essential in diagnosing a complicated case and avoiding unnecessary interventions.
Background: In the present study, we aimed to investigate the association between (EORTC) QLQ-C30 scores and both preoperative somatometric parameters and postoperative outcomes in elderly patients undergoing elective surgery for resectable colorectal cancer. Methods: The 118 elderly consecutive patients who underwent colorectal surgery for cancer in a single university’s surgical department between 01/2018 and 12/2018 were prospectively enrolled in the present study. All patients with an age > 65 years, diagnosed with resectable colorectal cancer, without metastatic disease, that underwent elective surgery were included prospectively in the present study. Results: Regarding patients’ characteristics, a negative correlation between preoperative QLQ (pQLQ) score and age (p = 0.001) and a positive correlation between body mass index (BMI) and pQLQ score (p = 0.048) were observed. Furthermore, there was a statistically significant difference (p = 0.004) in the mean pQLQ score between patients with rectal or colon cancer. Moreover, assessing pQLQ score was a useful tool in terms of postoperative recovery. Negative correlations between the pQLQ score and time (days) of beginning oral feeding (p < 0.001) and length of hospital stay (p = 0.004) were found. The pQLQ score was statistically significantly lower (p = 0.005) in patients who had any postoperative complication; however, there was no difference in patients with major complications. Conclusions: Advanced age, colon cancer and decreased BMI were negatively associated with preoperative QLQ. The assessment of pQLQ in elderly patients with colorectal cancer can be a useful predictive tool for postoperative complications, length of hospital stay and postoperative rehabilitation.