Morbidität, Mortalität und Analyse prognostischer Faktoren beim kolorektalen Karzinom

Clauer, U.; Schäfer, Juliane; Roder, J. D.

doi:10.1007/s00104-014-2867-y

Cited by 7 publications

(8 citation statements)

References 16 publications

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“…In accordance with current literature we found that patients with higher tumor stage and/or grade have a higher risk to develop DM both after early and late discontinuation of CTx and after completion of 12 months of CTx [ 26 ]. Interesting is the result regarding the worse survival prognosis of women after the development of LR compared to that of men.…”

Section: Discussionsupporting

confidence: 90%

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Advantages of a multi-state approach in surgical research: how intermediate events and risk factor profile affect the prognosis of a patient with locally advanced rectal cancer

Manzini

Ettrich

Kremer

et al. 2018

BMC Med Res Methodol

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BackgroundStandard survival analysis fails to give insight into what happens to a patient after a first outcome event (like first relapse of a disease). Multi-state models are a useful tool for analyzing survival data when different treatments and results (intermediate events) can occur. Aim of this study was to implement a multi-state model on data of patients with rectal cancer to illustrate the advantages of multi-state analysis in comparison to standard survival analysis.MethodsWe re-analyzed data from the RCT FOGT-2 study by using a multi-state model. Based on the results we defined a high and low risk reference patient. Using dynamic prediction, we estimated how the survival probability changes as more information about the clinical history of the patient becomes available.ResultsA patient with stage UICC IIIc (vs UICC II) has a higher risk to develop distant metastasis (DM) or both DM and local recurrence (LR) if he/she discontinues chemotherapy within 6 months or between 6 and 12 months, as well as after the completion of 12 months CTx with HR 3.55 (p = 0.026), 5.33 (p = 0.001) and 3.37 (p < 0.001), respectively. He/she also has a higher risk to die after the development of DM (HR 1.72, p = 0.023). Anterior resection vs. abdominoperineal amputation means 63% risk reduction to develop DM or both DM and LR (HR 0.37, p = 0.003) after discontinuation of chemotherapy between 6 and 12 months. After development of LR, a woman has a 4.62 times higher risk to die (p = 0.006). A high risk reference patient has an estimated 43% 5-year survival probability at start of CTx, whereas for a low risk patient this is 79%. After the development of DM 1 year later, the high risk patient has an estimated 5-year survival probability of 11% and the low risk patient one of 21%.ConclusionsMulti-state models help to gain additional insight into the complex events after start of treatment. Dynamic prediction shows how survival probabilities change by progression of the clinical history.Electronic supplementary materialThe online version of this article (10.1186/s12874-018-0476-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

“…Based on the results of the msm analysis and on current literature [ 14 , 24 – 26 , 30 ] we defined a high and low risk reference patient based on the baseline covariate profile, representing well the patients in the dataset.…”

Section: Discussionmentioning

confidence: 99%

Advantages of a multi-state approach in surgical research: how intermediate events and risk factor profile affect the prognosis of a patient with locally advanced rectal cancer

Manzini

Ettrich

Kremer

et al. 2018

BMC Med Res Methodol

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“…In our study, it was noted to be low (5%) compared with studies performed in Germany, Sweden, and France where surgical morbidity rates were reported to be 18%, 24%, and 35%, respectively. [29][30][31][32][33] In our study, 3 events were noted in patients with colon cancer and 9 in patients with rectal cancer. No deaths related to surgical treatment were noted.…”

Section: Morbiditymentioning

confidence: 45%

Treatment Outcomes of Patients With Colorectal Cancer Enrolled in a Comprehensive Benefits Program of the National Insurance System in the Philippines: Data From the Pilot Site

Ting

Sacdalan

Tampo

et al. 2020

JCO Global Oncology

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PURPOSE Cancer treatment causes significant financial burden, especially in developing countries such as the Philippines. This led the Philippine Department of Health to create the Z-Package colorectal cancer benefit program, an insurance system specifically designed to treat Filipinos with colorectal cancers with early to locally advanced-stage disease. The main goal of this program is to optimize treatment outcomes for this curable disease without causing financial toxicity. MATERIALS AND METHODS Three-year data on patients enrolled in the Z-Package colorectal cancer benefit program from 2016 to 2018 were reviewed by the University of the Philippines, Philippine General Hospital Colorectal Polyp and Cancer Study Group. RESULTS A total of 251 patients were enrolled in the Z-package colorectal cancer benefit program from 2016 to 2018. Mean age was 57 years old and a majority of patients (66%) were male. A majority of patients had rectal cancer (78%) and were diagnosed with stage III disease (82%). A majority (75%) were compliant to their treatment plans and clinic follow-up. Specifically, compliance to the prescribed surgery, chemotherapy, and/or radiation treatment were 90%, 77%, and 96%, respectively. Recurrence, morbidity, and mortality rates of enrolled patients in the Z-Package program from 2016 to 2018 were 17%, 22%, and 19%, respectively. Morbidities were mostly chemotherapy related (8%). Finally, patients in this program had a 2- and 3-year survival probability of 74% and 70%, respectively, which are comparable with data from more developed nations. CONCLUSION Results of this study include real-world data that show that when the highest standards of patient care are provided through a multidisciplinary team, patients’ overall survival is also maximized.

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“…Worldwide, with more than 1.9 million cases and 935.173 deaths a year, colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer death ( 1 ) for which surgery is the main treatment. However, approximately one-third of patients who undergo colorectal resection experience postoperative complications ( 2 , 3 ), which delay postoperative recovery, prolong hospital stays, lead to unplanned readmissions and reduce health-related quality of life ( 4 ). More than 65% of CRC patients are older than 65 years old ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of short-term prehabilitation of older patients with colorectal cancer: A propensity score-matched analysis

Wang

Chen²,

Ge³

et al. 2023

Front. Oncol.

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ObjectiveThe aim of this study was to assess the impact of short-term, hospital-based, supervised multimodal prehabilitation on elderly patients with colorectal cancer.MethodsA single-center, retrospective study was conducted from October 2020 to December 2021, which included a total of 587 CRC patients who were scheduled to undergo radical resection. A propensity score-matching analysis was performed to reduce selection bias. All patients were treated within a standardized enhanced recovery pathway, and patients in the prehabilitation group received an additional supervised, short-term multimodal preoperative prehabilitation intervention. Short-term outcomes were compared between the two groups.ResultsAmong the participants, 62 patients were excluded; 95 participants were included in the prehabilitation group and 430 in the non-prehabilitation group. After PSM analysis, 95 pairs of well-matched patients were included in the comparative study. Participants in the prehabilitation group had better preoperative functional capacity (402.78 m vs. 390.09 m, P<0.001), preoperative anxiety status (9% vs. 28%, P<0.001), time to first ambulation[25.0(8.0) hours vs. 28.0(12.4) hours, P=0.008], time to first flatus [39.0(22.0) hours vs. 47.7(34.0) hours, P=0.006], duration of the postoperative length of hospital stay [8.0(3.0) days vs. 10.0(5.0) days, P=0.007), and quality of life in terms of psychological dimensions at 1 month postoperatively [53.0(8.0) vs. 49.0(5.0), P<0.001].ConclusionThe short-term, hospital-based, supervised multimodal prehabilitation is feasible with a high degree of compliance in older CRC patients, which improves their short-term clinical outcomes.

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Morbidität, Mortalität und Analyse prognostischer Faktoren beim kolorektalen Karzinom

Abstract: Cardiovascular disease leads to a higher morbidity rate whereas age, International Union Against Cancer (UICC) stage, R-status, lymphatic spread and occurrence of complications are important prognostic factors for survival.

Cited by 7 publications

References 16 publications

Advantages of a multi-state approach in surgical research: how intermediate events and risk factor profile affect the prognosis of a patient with locally advanced rectal cancer

Advantages of a multi-state approach in surgical research: how intermediate events and risk factor profile affect the prognosis of a patient with locally advanced rectal cancer

Treatment Outcomes of Patients With Colorectal Cancer Enrolled in a Comprehensive Benefits Program of the National Insurance System in the Philippines: Data From the Pilot Site

Effect of short-term prehabilitation of older patients with colorectal cancer: A propensity score-matched analysis

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