Predictors of overall survival following extended radical resections for locally advanced and recurrent pelvic malignancies
| العنوان: | Predictors of overall survival following extended radical resections for locally advanced and recurrent pelvic malignancies |
|---|---|
| المؤلفون: | Tim Eglinton, Satish K Warrier, Peadar S Waters, Christopher Wakeman, Oliver Peacock, Joseph C Kong, Jacob J McCormick, Frank A. Frizelle, Alexander G. Heriot |
| المصدر: | Langenbeck's Archives of Surgery. 405:491-502 |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Extended radical, medicine.medical_specialty, business.industry, Locally advanced, Disease, 030230 surgery, Vascular surgery, Cardiac surgery, 03 medical and health sciences, 0302 clinical medicine, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Internal medicine, medicine, Rectal Adenocarcinoma, Surgery, business, Abdominal surgery |
| الوصف: | In an era of personalised medicine, there is an overwhelming effort for predicting patients who will benefit from extended radical resections for locally advanced pelvic malignancy. However, there is paucity of data on the effect of comorbidities and postoperative complications on long-term overall survival (OS). The aim of this study was to define predictors of 1-year and 5-year OS. Data were collected from prospective databases at two high-volume institutions specialising in beyond TME surgery for locally advanced and recurrent pelvic malignancies between 1990 and 2015. The primary outcome measures were 1-year and 5-year OS. A total of 646 consecutive extended radical resections were performed between 1990 and 2015. The majority were female patients (371, 57.4%) and the median age was 63 years (range 19–89 years). One-year OS, primary rectal adenocarcinoma had the best survival while recurrent colon cancer had the worse survival (p = 0.047). The 5-year OS between primary and recurrent cancers were 64.7% and 53%, respectively (p = 0.004). Poor independent prognostic markers for 5-year OS were increasing ASA score, cardiovascular disease, recurrent cancers, ovarian cancers, pulmonary embolus and acute respiratory distress syndrome. A positive survival benefit was demonstrated with preoperative radiotherapy (HR 0.55; 95% CI 0.4–0.75, p < 0.001). Patient comorbidities and specific complications can influence long-term survival following extended radical resections. This study highlights important predictors, enabling clinicians to better inform patients of the potential short- and long-term outcomes in the management of locally advanced and recurrent pelvic malignancy. |
| تدمد: | 1435-2451 1435-2443 |
| DOI: | 10.1007/s00423-020-01895-y |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::7b54a4bb91d9e9afc2976092ff44904f https://doi.org/10.1007/s00423-020-01895-y |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi...........7b54a4bb91d9e9afc2976092ff44904f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14352451 14352443 |
|---|---|
| DOI: | 10.1007/s00423-020-01895-y |