RESUMO
This systematic review investigates the intersection of early-onset colorectal cancer (EOCRC), sexual functioning, and associated quality of life (QoL), aiming to understand the comprehensive impact of EOCRC on these critical dimensions. Through an extensive search across PubMed, Scopus, and Embase up until November 2023, this study synthesized evidence from the literature while adhering to PRISMA guidelines. The studies included EOCRC patients under 50 years, which examined sexual functioning and QoL using validated instruments, and were published in English. After a rigorous screening process, five relevant studies were identified from an initial pool of 2184 articles. This review includes data from five studies involving 2031 EOCRC patients. The key findings revealed a high prevalence of sexual dysfunction, with up to 50% of men experiencing impotence and 58% reporting sexual dysfunction, alongside 36% of women in some studies. Pain was described by 12% to 31% of patients. Anxiety and depression were notably prevalent, affecting up to 69% of participants. EOCRC profoundly impacts sexual functioning and QoL, with a significant prevalence of sexual dysfunction and psychological distress among affected individuals. These findings suggest the need for oncological management strategies that include not only medical treatment but also psychological support and sexual health interventions. This systematic review emphasizes the importance of holistic patient care approaches, advocating for further research and clinical attention to address the complex needs of younger EOCRC patients.
RESUMO
Gastric cancer ranks as the fifth most common cancer, and the assessment of inflammatory biomarkers in these patients holds significant promise in predicting prognosis. Therefore, data from patients undergoing surgical intervention for gastric cancer over a 7-year period were analyzed. This study was retrospective and involved a preoperative investigation of six inflammatory parameters derived from complete blood counts. Statistical analysis revealed a significant increase in the leucocyte-to-monocyte ratio (LMR) (p = 0.048), along with a significant decrease in the number of lymphocytes and monocytes compared to patients with successful discharge. Taking into consideration patients undergoing emergency surgery, a significant increase in the LMR (p = 0.009), neutrophil-to-lymphocyte ratio (NLR) (p = 0.004), Aggregate Index of Systemic Inflammation (AISI) (p = 0.01), and Systemic Immune-Inflammation Index (SII) (p = 0.028) was observed. Regarding relapse, these patients exhibited significant increases in AISI (p = 0.032) and SII (p = 0.047). Inflammatory biomarkers represent a valuable tool in evaluating and predicting the prognosis of patients with gastric cancer.
RESUMO
The aim of this study was to quantify the impact of the COVID-19 pandemic on the surgical treatment of patients with gastric cancer. Data from patients undergoing surgery for gastric cancer during the pandemic were analyzed and the results obtained were compared with the corresponding periods of 2016-2017 and 2018-2019. Various parameters were taken into consideration and their dynamics highlight significant changes in the pandemic year compared with the two pre-pandemic periods. Statistical analysis revealed a marked decrease in the number of surgeries performed during the pandemic (p < 0.001). Severe prognostic factors for gastric cancer, including weight loss and upper gastrointestinal hemorrhage, were associated with an increased number of postoperative fistulas, while emesis was statistically correlated with a more advanced cancer stage (p < 0.011). There was also a reduction in the total duration of hospitalization (p = 0.044) and postoperative hospitalization (p = 0.047); moreover, the mean duration of surgical intervention was higher during the pandemic (p = 0.044). These findings provide evidence for the significant changes in clinical and therapeutic strategies applied to patients undergoing surgery for gastric cancer during the study period. The ongoing pandemic has exerted a substantial and complex impact, the full extent of which remains yet to be fully comprehended.
RESUMO
The aim of this study was to highlight the changes in the surgical treatment of patients with thyroid pathology over a 4-year period. The dynamics of various parameters during this period at a tertiary University Hospital in Timisoara, Romania were examined. Data from 1339 patients who underwent thyroid surgery between 26 February 2019 and 25 February 2023 were analyzed. The patients were divided into four groups: Pre-COVID-19, C1 (first year of the pandemic), C2 (second year), and C3 (third year). Multiple parameters of the patients were analyzed. Statistical analysis revealed a significant decrease in the number of surgical interventions performed during the first two years of the pandemic (p < 0.001), followed by an increase in subsequent periods (C3). Furthermore, an increase in the size of follicular tumors was observed during this period (p < 0.001), along with an increase in the proportion of patients with T3 and T4 stage in C3. There was also a reduction in the total duration of hospitalization, postoperative hospitalization, and preoperative hospitalization (p < 0.001). Additionally, there was an increase in the duration of the surgical procedure compared to the pre-pandemic period (p < 0.001). Moreover, correlations were observed between the duration of hospitalization and the duration of the surgical procedure (r = 0.147, p < 0.001), and between the duration of the surgical procedure and postoperative hospitalization (r = 0.223, p < 0.001). These findings confirm the modification of clinical and therapeutic management of patients who underwent thyroid surgery over the past 4 years, with the pandemic generating an impact whose full consequences are not yet fully known.