ABSTRACT
BACKGROUND: Pathologic complete response (pCR) after multimodal treatment for locally advanced rectal cancer (LARC) is used as surrogate marker of success as it is assumed to correlate with improved oncologic outcome. However, long-term oncologic data are scarce. METHODS: This retrospective, multicentre study updated the oncologic follow-up of prospectively collected data from the Spanish Rectal Cancer Project database. pCR was described as no evidence of tumour cells in the specimen. Endpoints were distant metastases-free survival (DMFS) and overall survival (OS). Multivariate regression analyses were run to identify factors associated with survival. RESULTS: Overall, 32 different hospitals were involved, providing data on 815 patients with pCR. At a median follow-up of 73.4 (IQR 57.7-99.5) months, distant metastases occurred in 6.4% of patients. Abdominoperineal excision (APE) (HR 2.2, 95%CI 1.2-4.1, p = 0.008) and elevated CEA levels (HR = 1.9, 95% CI 1.0-3.7, p = 0.049) were independent risk factors for distant recurrence. Age (years) (HR 1.1; 95%-CI 1.05-41.09; p < 0.001) and ASA III-IV (HR = 2.0; 95%-CI 1.4-2.9; p < 0.001), were the only factors associated with OS. The estimated 12, 36 and 60-months DMFS rates were 96.9%, 91.3%, and 86.8%. The estimated 12, 36 and 60-months OS rates were 99.1%, 94.9% and 89.3%. CONCLUSIONS: The incidence of metachronous distant metastases is low after pCR, with high rates of both DMFS and OS. The oncologic prognosis in LARC patients that achieve pCR after neoadjuvant chemo-radiotherapy is excellent in the long term.
Subject(s)
Humans , Female , Aged , Abdomen, Acute , Diverticulitis , Jejunum , Diverticulum , Abdominal Pain , Inpatients , Physical Examination , Gastroenterology , Gastrointestinal DiseasesSubject(s)
Abdomen, Acute/etiology , Diverticulitis/complications , Intestinal Perforation/complications , Jejunal Diseases/complications , Rare Diseases/complications , Aged , Diverticulitis/surgery , Female , Humans , Intestinal Perforation/surgery , Jejunal Diseases/surgery , Rare Diseases/surgerySubject(s)
Colitis, Ulcerative , Colitis , Adult , Animals , Colitis/diagnosis , Colitis/etiology , Colitis, Ulcerative/complications , Colitis, Ulcerative/diagnosis , Colon , Diagnostic Errors , Humans , StrongyloidesABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Squamous Cell , Hidradenitis Suppurativa/complications , Pelvic Neoplasms , Perineum/pathology , Fatal Outcome , Sacrum/pathologyABSTRACT
OBJECTIVES: Anal incontinence is a devastating affliction with several considerations that make it difficult to define in terms of epidemiology with good precision. The aim of the present work is to study the prevalence of an important disorder such as anal incontinence in a healthy working population within a sanitary environment. MATERIAL AND METHODS: A cluster of easy understanding and filling inquiry forms are distributed to 910 apparently healthy individuals at our hospital. This questionnaires include filiation data, passed medical history, presence or not of Incontinence and other symptoms such as urgency. The Cleveland Clinic Incontinence Score is also registered. RESULTS: Anal incontinence is present in a 21.2% of subjects when considered in any of it forms (flatus, liquid or solid faeces). A Clevleand Clinic Incontinence Score higher than 6 was obtained in a 7.3% of the sample and higher than 10 in 1.2%. No gender predominance has been identified. A slightly higher severity is recognised with increasing age. Obstetric and anal surgical background are the only related factors identified in the studied sample. CONCLUSIONS: Faecal incontinence is a high prevalent affliction, even among apparently healthy population. Considering the aetiologic factors that have been established, prevention during obstetric and anal surgical procedures is absolutely mandatory.
Subject(s)
Anal Canal/physiopathology , Fecal Incontinence/epidemiology , Fecal Incontinence/etiology , Health Personnel/statistics & numerical data , Adult , Age Distribution , Aged , Female , Humans , Logistic Models , Male , Manometry , Middle Aged , Multivariate Analysis , Prevalence , Risk Factors , Sex Distribution , Spain , Surveys and Questionnaires , Tertiary Care Centers , Ultrasonography , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Intestinal Obstruction/etiology , Duodenal Obstruction/etiology , Gallstones/complications , Laparotomy/methodsABSTRACT
We report a 48-year-old man in whom a chronic postbulbar duodenal ulcer destroyed much of the back wall of the duodenum and gastroduodenal artery causing pseudoaneurysm. The lesion was found and evaluated by contrast-enhanced computed tomography (that revealed a large pseudoaneurysm of 83 mm × 75 mm in diameter) and by angiography and then treated with transcatheter embolization leading to a complete resolution of the lesion. The case is rare and important for several reasons. First, we demonstrate that pseudoaneurysm of the gastroduodenal artery caused by a duodenal ulcer can occur and present a diagnostic challenge (as far as we know, only three cases have been reported previously in the literature). Second, this case report focuses on the importance of ligation of the gastroduodenal artery when bleeding of peptic ulcers occurs. Additionally, we present an overview of the relevant literature.
