Pattern of relapse after curative surgery for metastatic colorectal cancer

To investigate patterns in the relapse frequency after curative surgical intervention, with the intention of determining the feasibility of a complete holiday from chemotherapy for metastatic colorectal cancer [mCRC] patients. Patients with stage IV mCRC who received curative surgical intervention between January 1999 and December 2009 at Changhua Christian Hospital, Changhua, Taiwan were investigated retrospectively. Factors influencing the frequency and pattern of relapse were analyzed by logistic regression. Factors influencing overall survival [OS] were analyzed with Cox proportional hazard ratios. Significant factors were extracted and relationships to OS were evaluated by Kaplan-Meier with Log-Rank test. One hundred and thirty-two patients were included in the study in which 94 [71.2%] suffered from relapse. The number of relapses peaked between 3 and 6 months. The incidence of relapse and Disease-free survival had a negative influence on OS, with a hazard ratio [HR] of 0.36 [95% CI: 0.01-0.26] and 0.93 [95% CI: 0.90-0.95]. The prognosis was significantly worse when the relapse [n=25] occurred within 6 months after metastectomy [p<0.001]. Patients exhibited significantly better long-term OS if the relapse does not occur within 28 months after surgery [p<0.001]. Early relapse indicated a worse prognosis. We determined that if mCRC patients remain cancer-free for 28 months after curative surgery, their chance of long-term survival is significantly better

Efficacy and safety of tramadol/ acetaminophen in the treatment of breakthrough pain in cancer patients

We evaluated the analgesic efficacy and safety of tramadol 37.5 mg/ acetaminophen 325 mg combination tablet, for the treatment of breakthrough pain in cancer patients. This study was conducted at Changhua Christian Hospital, Changhua, Taiwan from January 2006 to February 2007. The single-center and open-label study enrolled 59 opioid-treated cancer patients with at least moderate breakthrough pain [visual analog scale [VAS] score >/= 40 mm on a 100-mm scale]. The efficacy measures included VAS scores and adverse effect assessment 10, 30, and 60 minutes after the administration of tramadol/ acetaminophen. Visual analog scale score at time of pain relief was reported. The mean VAS score when the breakthrough pain episode began [0 minute] was 77.8. Analysis showed significant better mean pain VAS scores at 10, 30, 60 minutes after the administration of tramadol/ acetaminophen [p