ABSTRACT
BACKGROUND: Leukocytes play an important role in cancer development. However, the impact of chemotherapy-associated neutropenia/lymphopenia on the prognosis of adjuvant chemotherapy is unknown. Here, we aimed to explore the impact of chemotherapy-associated neutrophil/lymphocyte counts on prognosis of adjuvant chemotherapy in colorectal cancer (CRC) and the risk factors for developing neutropenia/lymphopenia which showed impact on the prognosis of CRC receiving adjuvant chemotherapy. METHODS: From February 2003 to January 2011, 243 stage II and III CRC patients receiving adjuvant chemotherapy were enrolled in this retrospective study. The associations between neutrophil/ lymphocyte counts and disease free survival (DFS)/overall survival (OS) of CRC, and the risk factors for neutropenia/lymphopenia were investigated. RESULTS: No association of chemotherapy-associated neutrophil counts and CRC recurrence (AUC = 0.474, P = 0.534), death (AUC = 0.449, P = 0.249) was found by ROC analysis. However, the chemotherapy-associated lymphocyte counts could significantly affect CRC recurrence (AUC = 0.634, P = 0.001), or death(AUC = 0.607, P = 0.015), with a optimized cut-off of 0.66 × 10(9)/L for recurrence, and 0.91 × 10(9)/L for death, respectively. Kaplan-Meier method showed chemotherapy-associated lymphopenia <0.66 × 10(9)/L was associated with shorter DFS (P < 0.0001), and chemotherapy-associated lymphopenia <0.91 × 10(9)/L was associated with shorter OS (P = 0.003). Cox regression model showed chemotherapy-associated lymphopenia <0.66 × 10(9)/L was the independent prognostic factor for DFS (HR, 3.521; 95%CI = 1.703-7.282), and chemotherapy-associated lymphopenia <0.91 × 10(9)/L was the independent prognostic factor for OS (HR, 2.083; 95% CI = 1.103-3.936). Multivariate logistic regression showed the risk of developing chemotherapy-associated lymphopenia <0.66 × 10(9)/L was found in those with pretreatment CEA ≥10 ng ml(-1) (OR, 3.338; 95% CI = 1.523-7.315), and the risk of developing chemotherapy-associated lymphopenia <0.91 × 10(9)/L was found in those with age >60 years (OR, 2.872; 95% CI = 1.344-6.136). CONCLUSIONS: Chemotherapy-associated lymphopenia <0.66 × 10(9)/L /0.91 × 10(9)/L has a significant impact on the prognosis of CRC receiving adjuvant chemotherapy. Pretreatment CEA ≥10 ng ml(-1) is the independent risk factor for developing lymphopenia <0.66 × 109/L, and age >60 years is the independent risk factor for developing lymphopenia <0.91 × 10(9)/L during adjuvant chemotherapy of CRC.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colorectal Neoplasms/blood , Colorectal Neoplasms/drug therapy , Lymphocytes , Neutrophils , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chemotherapy, Adjuvant , Colorectal Neoplasms/mortality , Colorectal Neoplasms/pathology , Female , Humans , Leukocyte Count , Lymphopenia/chemically induced , Male , Middle Aged , Neoplasm Staging , Neutropenia/chemically induced , Prognosis , Recurrence , Risk Factors , Young AdultABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinicopathological features and prognosis of colorectal cancer patients with preoperative cancer-related anemia.</p><p><b>METHODS</b>Clinical data of 354 patients with colorectal cancer in the Second Affiliated Hospital of Guangzhou Medical College from January 2003 to July 2009 were analyzed retrospectively. Those with hemoglobin(Hb)<120 g/L before surgery were defined as cancer-related anemia.</p><p><b>RESULTS</b>Of the 354 colorectal cancer cases, 195 were males and 159 were females. The median age was 65(range 22-92) years. Preoperative cancer-related anemia tended to be occurred in female(P<0.01) and those with preoperative albumin ≤35 g/L (P<0.01), right colon cancer(P<0.01) and full-thickness invasion(P<0.05). Cox regression analysis showed preoperative cancer-related anemia was an independent unfavorable factor for overall survival (HR=1.60, 95% CI:1.05-2.44; P<0.05), but not for disease-free survival (HR=1.43, 95% CI:0.97-2.12; P>0.05) in colorectal cancer.</p><p><b>CONCLUSIONS</b>Preoperative cancer-related anemia plays an important role in the development and prognosis of colorectal cancer and great attention should be paid to clinical practice.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Anemia , Colorectal Neoplasms , General Surgery , Prognosis , Retrospective StudiesABSTRACT
Objective To evaluate and analyze the postoperative complications induced from the procedure for prolapse and hemorrhoids(PPH).Methods The data of the third or fourth degree hemorrhoids operated by pro- cedure for prolapse and hemorrhoids were analyzed.Results Total 224 patients with hemorrhoids were operated on by PPH,and the mean operative time was 25 minutes and mean postoperative hospital stay were 3.5 days.Postoper- ative bleeding requiring haemostatic procedures occurred in two patients.Urine retention rate was 30.36%,there were 56 eases pain scores＞5,there of re-prolapse,16 cases of residual skin tags.One case of mucocele.Conclusion The rule of PPH is individual management.
