Caloric intake capacity as measured by a standard nutrient drink test helps to predict weight loss after bariatric surgery.

BACKGROUND: Instruments that enable to select individuals that will benefit most from bariatric surgery (BS) are necessary to increase its cost-efficiency. Our goal was to assess if intake capacity, measured with a standardized test, predicts response to BS. METHODS: Patients with criteria for BS were randomly allocated to laparoscopic gastric bypass (LRYGB) or sleeve gastrectomy (LSG). We measured caloric intake capacity before and 1 year after surgery using a standardized nutrient drink test. We evaluated if pre-surgery satiation could predict satiation and weight loss (%) 1 year after surgery using multiple regression modeling. Descriptive statistics are given as mean ± SD. RESULTS: Fourteen women (48 ± 9 years old, BMI 41 ± 3 kg/m(2)) were evaluated before and 11 ± 2.6 months after surgery (seven LRYGB, seven LSG). Caloric intake capacity diminished after surgery (-950 ± 85 kcal on average [70 ± 8 % decrease over basal intake capacity]; p=0.002) and similarly in both LRYGB (72 ± 7 % decrease) and LSG groups (68 ± 8 % decrease); p=0.5. There was a significant weight reduction after surgery (-32 ± 10 kg [30 ± 8 % of total basal weight]) with a mean post-surgery BMI of 29 ± 2 kg/m(2). The best predictive model of weight loss (%) after surgery (R (2)=89 %, p=0.0009) included: BMI (p=0.0004), surgery type (p=0.01) and pre-surgery intake capacity (p=0.006). Weight loss was higher in heavier patients and those undergoing LRYGB. Patients with higher intake capacity had a poorer outcome independently of basal BMI and surgery type. CONCLUSIONS: Caloric intake capacity, as measured by a standard nutrient drink test, helps to predict weight loss after bariatric surgery. This test might be useful in algorithms of obesity treatment decision.

Colorectal cancer survival: results from a hospital-based cancer registry / Supervivencia del cáncer colorrectal: resultados de un registro hospitalario

Introduction: colorectal cancer is one of the most common malignancies in developed countries. Data on specific and 10-year survival are scarce. This study analyzes overall and disease-specific survival for patients with colorectal cancer and assesses the value of clinical factors on disease-specific survival. Methods: a retrospective cohort study of newly diagnosed invasive colorectal cancer cases diagnosed from 1992 to 2007 were identified through the Hospital del Mar Cancer Registry. Five- and 10-year survival functions were estimated using Kaplan-Meier method. Cox proportional hazard models were used to assess prognostic factors. Results: a total of 2,080 patients with colorectal cancer were identified. The median age at diagnosis was 72 years and 58.5% were men. By the end of the follow-up period (December 2008), ,225 patients had died and 68.4% of deaths were due to colorectal cancer. The 5- and 10-year cancer-specific survival rates were 55.5% (95%CI 53.9-57.9%) and 48.5% (95%CI 45.6-51.3%), respectively. The 5-year specific survival rate improved in the last period (2003- 2007) (60.4%, 95%CI 55.4-65.0) compared with 1992-1997 (53.4%; 95%CI 49.2-57.4) and 1998-2002 (52.0%; 95%CI 47.8- 56.2). Various factors were independently associated with excess CRC mortality: male sex (HR 1.21), age at diagnosis > 75 years (HR 1.97), rectal location (HR 1.33), more advanced stages (stage IV: HR 18.54), poorly differentiated/undifferentiated tumors (HR 1.80), and admission through the emergency department (HR 1.52). Conclusions: cancer-specific survival improved from 1992 to 2007. This improvement could be due to more effective treatment, since changes in stage distribution or age at diagnosis were not observed during the study period. Overall survival rates should notably improve with the implementation of a population-based colorectal cancer screening program in Spain(AU)

Colorectal cancer survival: results from a hospital-based cancer registry.

INTRODUCTION: colorectal cancer is one of the most common malignancies in developed countries. Data on specific and 10-year survival are scarce. This study analyzes overall and disease-specific survival for patients with colorectal cancer and assesses the value of clinical factors on disease-specific survival. METHODS: a retrospective cohort study of newly diagnosed invasive colorectal cancer cases diagnosed from 1992 to 2007 were identified through the Hospital del Mar Cancer Registry. Five-and 10-year survival functions were estimated using Kaplan-Meier method. Cox proportional hazard models were used to assess prognostic factors. RESULTS: a total of 2,080 patients with colorectal cancer were identified. The median age at diagnosis was 72 years and 58.5%were men. By the end of the follow-up period (December 2008), 1,225 patients had died and 68.4% of deaths were due to colorectal cancer. The 5- and 10-year cancer-specific survival rates were 55.5% (95%CI 53.9-57.9%) and 48.5% (95%CI 45.6-51.3%), respectively. The 5-year specific survival rate improved in the last period (2003-2007) (60.4%, 95%CI 55.4-65.0) compared with 1992-1997(53.4%; 95%CI 49.2-57.4) and 1998-2002 (52.0%; 95%CI 47.8-56.2). Various factors were independently associated with excess CRC mortality: male sex (HR 1.21), age at diagnosis > 75 years(HR 1.97), rectal location (HR 1.33), more advanced stages (stage IV: HR 18.54), poorly differentiated/undifferentiated tumors (HR 1.80), and admission through the emergency department (HR 1.52). CONCLUSIONS: cancer-specific survival improved from 1992 to 2007. This improvement could be due to more effective treatment, since changes in stage distribution or age at diagnosis were not observed during the study period. Overall survival rates should notably improve with the implementation of a population-based colorectal cancer screening program in Spain.

Adenocarcinoma esofágico y esófago de Barrett. Adenocarcinoma gástrico y Helicobacter pylori / Esophageal adenoma-carcinoma and Barrett's esophagus. Gastric adenocarcinoma and Helicobacter pylori

En las últimas dos décadas se ha observado un aumentoprogresivo de la incidencia de cáncer de esófago, especialmentelos adenocarcinomas localizados en la unión esofagogástrica,mientras que la incidencia de cáncer gástrico se hareducido en las últimas décadas, aunque este decrementopresenta gran variabilidad geográfica, países como Chile,Colombia o Irlanda mantienen una prevalencia alta y laafección sigue siendo la neoplasia más frecuente en ambossexos en regiones como China o Japón. Entre todos los trabajospresentados en el congreso de la American GastroenterologicalAssociation (AGA) sobre prevención y tratamientodel cáncer gastroesofágico, destacan las siguientesaportaciones.En el esófago de Barrett (EB), deben mejorarse la implementacióndel uso de las guías clínicas para incrementar su aplicaciónen la prevención y la vigilancia del trastorno; el tratamientocon inhibidores de la bomba de protones (IBP) noparece reducir el riesgo de cáncer esofágico; la terapia endoscópicadel cáncer intramucoso mediante resección completade la mucosa es efectiva. Respecto al cáncer gástrico enpresencia de Helycobacter pylori, eliminarlo previene el desarrollode cáncer gástrico metacrónico en pacientes tratadosde un primer adenocarcinoma intramucoso mediante resecciónendoscópica. Los pacientes con linfoma MALT tienenun riesgo de contraer cáncer gástrico que es 6 veces el de lapoblación general. La terapia fotodinámica puede ser una alternativapara el tratamiento del adenocarcinoma gástrico®no visible», siempre seguida de controles endoscópicos(AU)

In the last two decades, the incidence of esophageal cancerhas progressively increased, especially that of adenocarcinomaslocalized in the esophagogastric junction. The incidenceof gastric cancer has decreased in the last few decades, althoughthis decrease shows wide geographical variations.Thus, the prevalence of gastric cancer continues to be highin countries such as Chile, Colombia and Ireland and thisdisease remains the most frequent neoplasm in both sexes inChina and Japan. In the meeting of the American GastroenterologicalAssociation, notable among all the studies presentedon the prevention and treatment of esophageal andgastric cancer were the following contributions: the use ofclinical practice guidelines for the prevention and surveillanceof Barrett’s esophagus (BE) should be improved; treatmentwith proton pump inhibitors does not seem to reducethe risk of esophageal cancer; endoscopic therapy of intramucosalcancer through complete mucosal resection is effective;Helicobacter pylori eradication prevents the developmentof metachronous gastric cancer in patients treated fora first intramucosal adenocarcinoma through endoscopic resection;the risk of developing gastric cancer is 6 times higherin patients with mucosa-associated lymphoid tissue(MALT) lymphoma than in the general population; andphotodynamic therapy may be an alternative for the treatmentof “invisible” gastric adenocarcinoma, which shouldbe followed-up endoscopically(AU)

[Esophageal adenoma-carcinoma and Barrett's esophagus. Gastric adenocarcinoma and Helicobacter pylori]. / Adenocarcinoma esfágico y esófago de Barrett. Adenocarcinoma gástrico y Helicobacter pylori.

In the last two decades, the incidence of esophageal cancer has progressively increased, especially that of adenocarcinomas localized in the esophagogastric junction. The incidence of gastric cancer has decreased in the last few decades, although this decrease shows wide geographical variations. Thus, the prevalence of gastric cancer continues to be high in countries such as Chile, Colombia and Ireland and this disease remains the most frequent neoplasm in both sexes in China and Japan. In the meeting of the American Gastroenterological Association, notable among all the studies presented on the prevention and treatment of esophageal and gastric cancer were the following contributions: the use of clinical practice guidelines for the prevention and surveillance of Barrett's esophagus (BE) should be improved; treatment with proton pump inhibitors does not seem to reduce the risk of esophageal cancer; endoscopic therapy of intramucosal cancer through complete mucosal resection is effective; Helicobacter pylori eradication prevents the development of metachronous gastric cancer in patients treated for a first intramucosal adenocarcinoma through endoscopic resection; the risk of developing gastric cancer is 6 times higher in patients with mucosa-associated lymphoid tissue (MALT) lymphoma than in the general population; and photodynamic therapy may be an alternative for the treatment of "invisible" gastric adenocarcinoma, which should be followed-up endoscopically.