1
|
Zhang D, Wang X, Zhang M, Yin Y, Guo J. Clinical efficacy of chemotherapy in colorectal cancer patients over 80 years old. Int J Colorectal Dis 2022; 37:1853-1863. [PMID: 35857106 PMCID: PMC9388411 DOI: 10.1007/s00384-022-04222-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Colorectal cancer (CRC) is a common and aggressive gastrointestinal cancer, and the prognostic impact associated with chemotherapy in super elderly (over 80 years old) patients remains poorly defined. We aimed to define the effect of chemotherapy on the prognosis of patients with CRC over 80 years old. PATIENTS AND METHODS A retrospective study including CRC patients over 80 years old was conducted. The patients were screened from the Surveillance Epidemiology and End Results (SEER) database from 2010 to 2015. Overall survival (OS) and cancer-specific survival (CSS) were applied as the primary and secondary outcome. Cox proportional hazards regression models were used to evaluate factors associated with OS and CSS. Survival curves of OS and CSS were estimated by Kaplan-Meier method and compared by log-rank test. RESULTS In total, 14,748 CRC patients over 80 years old were included in this study. The median patient age was 85 (IQR: 82-87). All patients were divided into surgical group and non-surgical group. The OS and CSS of the surgical group were significantly better than those of the non-surgical group (P < 0.001). Chemotherapy can improve OS and CSS for patients with stage III and IV (P < 0.001) in surgical group. For the super elderly patients with CRC, chemotherapy significantly improved OS and CSS in all TNM stages in non-surgical group. CONCLUSION For super elderly patients with colorectal cancer, tumor treatment should not be abandoned because of their age. It is necessary to carry out clinical trials in super elderly patients.
Collapse
Affiliation(s)
- Dongdong Zhang
- Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong University, 247 Beiyuan Street, Jinan, Shandong People’s Republic of China
| | - Xue Wang
- Jinan Maternal and Child Health Hospital, Jinan, 250001 Shandong China
| | - Mingbao Zhang
- Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong University, 247 Beiyuan Street, Jinan, Shandong People’s Republic of China
| | - Yafei Yin
- Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong University, 247 Beiyuan Street, Jinan, Shandong People’s Republic of China
| | - Jianqiang Guo
- Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong University, 247 Beiyuan Street, Jinan, Shandong People’s Republic of China
| |
Collapse
|
2
|
Badic B, Oguer M, Cariou M, Kermarrec T, Bouzeloc S, Nousbaum JB, Robaszkiewicz M, Quénéhervé L. Ostomy prevalence and survival in elderly patients with stage III and IV rectal cancer. Geriatr Gerontol Int 2021; 21:670-675. [PMID: 34189871 DOI: 10.1111/ggi.14225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/02/2021] [Accepted: 06/14/2021] [Indexed: 11/27/2022]
Abstract
AIM Oncological strategies in the elderly population are often debated. The objective of this study was to investigate the survival rates and prevalence of ostomy in elderly patients operated on for stage III and IV rectal cancers. METHODS This retrospective multicentric population-based study included 151 patients aged ≥75 years with stage III and IV rectal adenocarcinoma who underwent surgery between 2007 and 2014. Multivariable logistic regression was used to assess the impact of different prognostic factors. RESULTS The median age of the patients was 81 years (range: 75-97 years) with 40 patients >85 years of age. Age was significantly correlated with overall survival (OS) in both stage III and IV cancers (P < 0.001). For patients ≥80 years the presence of comorbid conditions was associated with a lower chance of survival (P = 0.02). A digestive stoma was created in 67 (76.1%) patients with stage III cancer and 26 (29.54%) had a stoma reversal. A palliative derivative stoma was performed in half of patients with stage IV cancer. Adjuvant chemotherapy was independently associated with improved 5-year OS (P < 0.001). CONCLUSIONS Age, comorbidities and adjuvant chemotherapy were independent predictors for OS. Resection of rectal tumors in fit elderly patients should be promoted; however, patients should be aware of the high risk of stoma. Geriatr Gerontol Int 2021; 21: 670-675.
Collapse
Affiliation(s)
- Bogdan Badic
- CHRU Brest, Service de Chirurgie Viscérale, Brest, France.,INSERM, UMR 1101, LaTIM, Brest, France
| | - Maude Oguer
- CHRU Brest, Service de Chirurgie Viscérale, Brest, France.,INSERM, UMR 1101, LaTIM, Brest, France
| | - Melanie Cariou
- Registre des Cancers Digestifs du Finistère, Brest, France.,EA7479 SPURBO, Université de Bretagne Occidentale, Brest, France
| | - Tiphaine Kermarrec
- Registre des Cancers Digestifs du Finistère, Brest, France.,EA7479 SPURBO, Université de Bretagne Occidentale, Brest, France
| | - Servane Bouzeloc
- Registre des Cancers Digestifs du Finistère, Brest, France.,EA7479 SPURBO, Université de Bretagne Occidentale, Brest, France
| | - Jean-Baptiste Nousbaum
- Registre des Cancers Digestifs du Finistère, Brest, France.,EA7479 SPURBO, Université de Bretagne Occidentale, Brest, France.,CHRU Brest, Service d'Hépato-gastro-entérologie, Brest, France
| | - Michel Robaszkiewicz
- Registre des Cancers Digestifs du Finistère, Brest, France.,EA7479 SPURBO, Université de Bretagne Occidentale, Brest, France.,CHRU Brest, Service d'Hépato-gastro-entérologie, Brest, France
| | - Lucille Quénéhervé
- Registre des Cancers Digestifs du Finistère, Brest, France.,EA7479 SPURBO, Université de Bretagne Occidentale, Brest, France.,CHRU Brest, Service d'Hépato-gastro-entérologie, Brest, France
| |
Collapse
|
3
|
Zhu G, Wu C, Shen X. Rapid rehabilitation nursing improves clinical outcomes in postoperative patients with colorectal carcinoma: A protocol for randomized controlled trial. Medicine (Baltimore) 2020; 99:e22857. [PMID: 33157927 PMCID: PMC7647534 DOI: 10.1097/md.0000000000022857] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Colorectal carcinoma has a high incidence rate and the high mortality rate has always been an important global health challenge. Surgical treatment is widely performed in patients with colorectal carcinoma. Fast track surgery (FTS) applies evidence-based medical concept to optimize the management during the operation, so as to reduce the psychological and physical trauma stress of surgical patients and make them recover rapidly. We perform this protocol for randomized controlled study to evaluate the efficacy of a rapid rehabilitation care in colorectal carcinoma surgery. METHODS It is a single-center randomized controlled study to be conducted from January 2021 to December 2021. It was authorized via the Ethics Committee of the Huzhou Central Hospital (20191127-01). Eighty participants who undergo colorectal carcinoma surgery will be included in this research. Patients are randomly assigned to control group (standard management group, including 40 samples) and study group (the FTS group, including 40 samples). The main results are times of postoperative exhaust, first defecation, ambulation, first eating, and postoperative hospital stay. Secondary outcomes are incidence of nausea and emesis, wound infection, urinary tract infection, lung infection, deep vein thrombosis, and rehospitalization rate among the 2 groups. All analyses are conducted using the SPSS for Windows Release 15.0. RESULTS Figure 1 shows the clinical results between groups. CONCLUSION The research can offer a reliable basis for the effectiveness of a rapid recovery nursing program in patients with colorectal carcinoma. TRIAL REGISTRATION This study protocol was registered in Research Registry (researchregistry6038).
Collapse
|
4
|
Garbarino GM, Costa G, Frezza B, Biancafarina A, Balducci G, Mercantini P, De Prizio M, Laracca GG, Ceccarelli G. Robotic versus open oncological gastric surgery in the elderly: a propensity score-matched analysis. J Robot Surg 2020; 15:741-749. [PMID: 33151485 PMCID: PMC8423642 DOI: 10.1007/s11701-020-01168-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/24/2020] [Indexed: 01/31/2023]
Abstract
Although there is no agreement on a definition of elderly, commonly an age cutoff of ≥ 65 or 75 years is used. Even if robot-assisted surgery is a validated option for the elderly population, there are no specific indications for its application in the surgical treatment of gastric cancer. The aim of this study is to evaluate the safety and feasibility of robot-assisted gastrectomy and to compare the short and long-term outcomes of robot-assisted (RG) versus open gastrectomy (OG). Patients aged ≥ 70 years old undergoing surgery for gastric cancer at the Department of Surgery of San Donato Hospital in Arezzo, between September 2012 and March 2017 were enrolled. A 1:1 propensity score matching was performed according to the following variables: age, Sex, BMI, ASA score, comorbidity, T stage and type of resection performed. 43 OG were matched to 43 RG. The mean operative time was significantly longer in the RG group (273.8 vs. 193.5 min, p < 0.01). No differences were observed in terms of intraoperative blood loss, an average number of lymph nodes removed, mean hospital stay, morbidity and mortality. OG had higher rate of major complications (6.9 vs. 16.3%, OR 2.592, 95% CI 0.623–10.785, p = 0.313) and a significantly higher postoperative pain (0.95 vs. 1.24, p = 0.042). Overall survival (p = 0.263) and disease-free survival (p = 0.474) were comparable between groups. Robotic-assisted surgery for oncological gastrectomy in elderly patients is safe and effective showing non-inferiority comparing to the open technique in terms of perioperative outcomes and overall 5-year survival.
Collapse
Affiliation(s)
- Giovanni Maria Garbarino
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-39, 00189, Rome, Italy.
| | - Gianluca Costa
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-39, 00189, Rome, Italy
| | - Barbara Frezza
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-39, 00189, Rome, Italy.,Division of General Surgery, Department of Surgery, San Donato Hospital, via Pietro Nenni 20-22, 52100, Arezzo, Italy
| | - Alessia Biancafarina
- Division of General Surgery, Department of Surgery, San Donato Hospital, via Pietro Nenni 20-22, 52100, Arezzo, Italy
| | - Genoveffa Balducci
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-39, 00189, Rome, Italy
| | - Paolo Mercantini
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-39, 00189, Rome, Italy
| | - Marco De Prizio
- Division of General Surgery, Department of Surgery, San Donato Hospital, via Pietro Nenni 20-22, 52100, Arezzo, Italy
| | - Giovanni Gugliemo Laracca
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-39, 00189, Rome, Italy
| | - Graziano Ceccarelli
- Division of General Surgery, Department of Surgery, San Donato Hospital, via Pietro Nenni 20-22, 52100, Arezzo, Italy.,Division of General Surgery, Department of Surgery, San Giovanni Battista Hospital, Local Health Service Umbria 2, via Massimo Arcamone 1, 06034, Foligno, PG, Italy
| |
Collapse
|
5
|
Costa G, Frezza B, Fransvea P, Massa G, Ferri M, Mercantini P, Balducci G, Buondonno A, Rocca A, Ceccarelli G. Clinico-pathological Features of Colon Cancer Patients Undergoing Emergency Surgery: A Comparison Between Elderly and Non-elderly Patients. Open Med (Wars) 2019; 14:726-734. [PMID: 31637303 PMCID: PMC6778396 DOI: 10.1515/med-2019-0082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/07/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most common cancers in patients older than 65 years. Emergency presentation represents about 30% of cases, with increased morbidity and mortality rates. The aim of this study is to compare the perioperative outcome between elderly and non-elderly patients undergoing emergency surgery. METHOD We retrospectively analysed CRC patients that underwent emergency surgery at the Departments of Surgery of the Sapienza University Sant'Andrea Hospital in Rome, and at San Donato Hospital in Arezzo, between June 2012 and June 2017. Patients were divided into two groups: non-elderly (< 65 years) and elderly (≥ 65 years). Variables analysed were sex, onset symptoms, associated disease, ASA score, tumor site and TNM stage, surgical procedures and approach, and morbidity and mortality. RESULTS Of a total of 123 patients, 29 patients were non-elderly and 94 patients were elderly. No significant differences were observed in sex, onset symptoms and tumor site between the two groups. Comorbidities were significantly higher in elderly patients (73.4% vs 41.4%, p<0.001). No significant differences were observed between the two groups in surgical approach and the rate of one-stage procedures. Elderly patients were more frequently treated by Hartmann's procedure compared to non-elderly patients (20.2% vs 6.9%). Left colorectal resection with protective ileostomy was most frequent in the non-elderly group (27.6% vs 11.7%). No significant differences were found in the pT and pN categories of the TNM system between the two groups. However, a higher number of T3 in non-elderly patients was observed. A consistent number of non-oncologically adequate resections were observed in the elderly (21.3% vs 3.5%; p<0.03). The morbidity rate was significantly higher in the elderly group (31.9 % vs 3.4%, p<0.001). No significant difference was found in the mortality rate between the two groups, being 13.8% in the elderly and 6.9% in the non-elderly. CONCLUSIONS Emergency colorectal surgery for cancer still presents significant morbidity and mortality rates, especially in elderly patients. More aggressive tumors and advanced stages were more frequent in the non-elderly group and as a matter it should be taken into account when treating such patients in the emergency setting in order to perform a radical procedure as much as possible.
Collapse
Affiliation(s)
- Gianluca Costa
- Surgical and Medical Department of Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189Rome, Italy
| | - Barbara Frezza
- Surgical and Medical Department of Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189Rome, Italy
- Department of Surgery, Division of General Surgery, San Donato Hospital, via Pietro Nenni 20-22, 52100Arezzo, Italy
| | - Pietro Fransvea
- Surgical and Medical Department of Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189Rome, Italy
| | - Giulia Massa
- Surgical and Medical Department of Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189Rome, Italy
| | - Mario Ferri
- Surgical and Medical Department of Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189Rome, Italy
| | - Paolo Mercantini
- Surgical and Medical Department of Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189Rome, Italy
| | - Genoveffa Balducci
- Surgical and Medical Department of Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189Rome, Italy
| | - Antonio Buondonno
- Surgical and Medical Department of Translational Medicine, Sapienza University of Rome, Sant’Andrea Hospital, Via di Grottarossa 1035-39, 00189Rome, Italy
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Aldo Rocca
- Colorectal Surgical Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori “Fondazione Giovanni Pascale” IRCCS, Naples, Italy
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Graziano Ceccarelli
- Department of Surgery, Division of General Surgery, San Donato Hospital, via Pietro Nenni 20-22, 52100Arezzo, Italy
| |
Collapse
|
6
|
Surgical approach and geriatric evaluation for elderly patients with colorectal cancer. Updates Surg 2019; 71:411-417. [PMID: 30953329 DOI: 10.1007/s13304-019-00650-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/25/2019] [Indexed: 12/14/2022]
Abstract
This review aims to define the most appropriate surgical approach and geriatric evaluation for elderly patients with colorectal cancer (CRC). Surgery represents the main treatment for CRC, but elderly cancer patients still represent a challenge for the surgeon due to frequent comorbidities such as cardiovascular and pulmonary diseases, which increase operative risk as well as the risk of postoperative morbidity and mortality. Cancer patients with comorbidities show lower survival rates and quality of life, together with higher healthcare costs. There is also evidence that patients with comorbidities sometimes receive modified treatment, compromising optimal care. To optimize treatment, the approach to elderly cancer patients needs a multidisciplinary team to assess preoperative conditions, prevent post-surgical complications and improve outcome, especially for frail patients. Laparoscopic surgery for CRC shows a number of advantages compared to conventional surgery such as less postoperative pain, rapid return to prior activities and a decrease in costs. Recent studies confirm that laparoscopic procedures could be performed safely on both older and younger patients with no difference compared with open surgery as regards morbidity or length of hospital stay.
Collapse
|
7
|
[Colorectal cancer in the elderly. Surgical treatment, chemotherapy, and contribution from geriatrics]. Rev Esp Geriatr Gerontol 2017; 52:261-270. [PMID: 28126268 DOI: 10.1016/j.regg.2016.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 10/14/2016] [Indexed: 12/12/2022]
Abstract
Age is the biggest risk factor for colorectal cancer, with 70% of the cases in patients over 70 years old. For this reason, a review is presented on the surgical treatment and chemotherapy of cancer of colon and rectum in the elderly. A search was performed in PubMed, including words such as elderly, surgery, colorectal cancer, chemotherapy, radiotherapy, and oncogeriatrics, and review articles and originals on treatment of colorectal cancer in the elderly were selected. A narrative form was developed from the latest evidence with the results obtained on the treatment of this pathology. Although the treatment of colorectal cancer is standardised, a prior comprehensive geriatric assessment is required in the case of the elderly, before deciding the type of treatment in order to offer these robust elderly-standardised guidelines for the robust elderly and adapt them for use in fragile patients.
Collapse
|
8
|
Tabola R, Mantese G, Cirocchi R, Gemini A, Grassi V, Boselli C, Avenia S, Sanguinetti A, Avenia N, Sroczynski M, Wierzbicki J. Postoperative mortality and morbidity in older patients undergoing emergency right hemicolectomy for colon cancer. Aging Clin Exp Res 2016; 29:121-126. [PMID: 27830519 DOI: 10.1007/s40520-016-0643-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 10/12/2016] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Even with the advances in surgical technique and perioperative care, morbidity and mortality after colorectal cancer surgery remain considerable, and patients (pt) who present as an emergency have an even higher mortality and morbidity rate. METHODS A total of 35 pt with caecum or ascending colon cancer between January 2007 and June 2015, three departments in Italy and in Poland, were included in the study. The intention of surgery in all cases was curative resection with ileo-colic anastomosis. Comparative statistical analysis was performed. RESULTS Acute bowel obstruction was the major complication of CRC that led to an emergency hemicolectomy. Postoperative mortality and morbidity rates were in total 12.5 and 28.1%, respectively. All the deaths happened in Poland. Of the pt, 42.8% had morbidity in Poland and 16.6% in Italy. Out of the pt, 25% presenting with perforation: 25% died, 25% had wound dehiscence, 12.5% had pulmonary oedema, and 12.5% had an intra-abdominal abscess. The mean age of the pt with complications in Poland and in Italy was 79.3 and 72.0 years, respectively. CONCLUSION We observed that particularly lethal combination is older age, perforation with peritonitis and advanced stage of the cancer.
Collapse
Affiliation(s)
- Renata Tabola
- Department of Gastrointestinal and General Surgery, Medical University of Wrocław, ul. Curie-Sklodowskiej 66, 50-369, Wrocław, Poland
| | - George Mantese
- Department of Gastrointestinal and General Surgery, Medical University of Wrocław, ul. Curie-Sklodowskiej 66, 50-369, Wrocław, Poland
| | - Roberto Cirocchi
- Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte 1, 06134, Perugia, Italy.
| | - Alessandro Gemini
- Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte 1, 06134, Perugia, Italy
| | - Veronica Grassi
- Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte 1, 06134, Perugia, Italy
| | - Carlo Boselli
- Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte 1, 06134, Perugia, Italy
| | - Stefano Avenia
- Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio 1, 05100, Terni, Italy
| | - Alessandro Sanguinetti
- Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio 1, 05100, Terni, Italy
| | - Nicola Avenia
- Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio 1, 05100, Terni, Italy
| | - Maciej Sroczynski
- Department of Minimally Invasive Surgery and Proctology, Medical University of Wroclaw, ul. Borowska 213, 50-556, Wrocław, Poland
| | - Jaroslaw Wierzbicki
- Department of Minimally Invasive Surgery and Proctology, Medical University of Wroclaw, ul. Borowska 213, 50-556, Wrocław, Poland
| |
Collapse
|
9
|
Shieh SI, Lin YH, Huang CY, Kao CC, Hung SL, Yang HY, Tung HY. Sexual dysfunction in males following low anterior resection. J Clin Nurs 2016; 25:2348-56. [PMID: 27080210 DOI: 10.1111/jocn.13172] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2015] [Indexed: 12/24/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to explore the prevalence of sexual dysfunction in males one year after undergoing low anterior resection and to determine whether health care professionals discuss sexual issues with patients after surgery. BACKGROUND Sexual dysfunction in males may be a complication after low anterior resection for rectal cancer, but few studies have explored this issue in Taiwan. DESIGN A descriptive comparison study design. METHODS A descriptive comparison design was used, and a group of 133 participants underwent a low anterior resection procedure for rectal cancer. The results were compared with those of a group of males who underwent colectomy (n = 58) for colon cancer. The following instruments were used: the five-item version of the International Index of Erectile Function, personal demographics and medical variables. RESULTS The results showed that the prevalence of erectile dysfunction among the low anterior resection patients was 97·0% (129/133), and the erectile dysfunction prevalence was 75·9% (44/58) for the males who underwent colectomy. The generalised linear model showed that after controlling for hypertension and stoma, the low anterior resection group had worse sexual function than those in the colectomy group, and stoma was also a factor that impacted patients' sexual function. The results also revealed that only 32·8-35·3% of health care providers talked about sexual dysfunction with people who have rectal cancer prior to surgery. CONCLUSION This study demonstrated that men who have undergone low anterior resection have a high risk of sexual dysfunction and that health care professionals infrequently discuss these issues with patients. RELEVANCE TO CLINICAL PRACTICE When patients are diagnosed with rectal cancer and before they undergo surgery, an assessment and discussion of sexual function issues should be incorporated into standard care. Continued follow-up after hospital discharge and evaluations of sexual function are vital factors for male postoperative rectal cancer patients.
Collapse
Affiliation(s)
- Show-Ing Shieh
- College of Liberal Education, Shu-Te University, Kaohsiung, Taiwan
| | - Yu-Hua Lin
- Nursing Department, I-Shou University, Kaohsiung, Taiwan
| | | | - Chia-Chan Kao
- Nursing Department, I-Shou University, Kaohsiung, Taiwan
| | - Shu-Ling Hung
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Hsing-Yu Yang
- Department of Nursing, Mackay Medical College, Taipei, Taiwan
| | - Hong-Yu Tung
- Medical Education & Research Department, Yuan's General Hospital, Kaohsiung, Taiwan
| |
Collapse
|
10
|
Papamichael D, Audisio RA, Glimelius B, de Gramont A, Glynne-Jones R, Haller D, Köhne CH, Rostoft S, Lemmens V, Mitry E, Rutten H, Sargent D, Sastre J, Seymour M, Starling N, Van Cutsem E, Aapro M. Treatment of colorectal cancer in older patients: International Society of Geriatric Oncology (SIOG) consensus recommendations 2013. Ann Oncol 2014; 26:463-76. [PMID: 25015334 DOI: 10.1093/annonc/mdu253] [Citation(s) in RCA: 275] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most commonly diagnosed cancers in Europe and worldwide, with the peak incidence in patients >70 years of age. However, as the treatment algorithms for the treatment of patients with CRC become ever more complex, it is clear that a significant percentage of older CRC patients (>70 years) are being less than optimally treated. This document provides a summary of an International Society of Geriatric Oncology (SIOG) task force meeting convened in Paris in 2013 to update the existing expert recommendations for the treatment of older (geriatric) CRC patients published in 2009 and includes overviews of the recent data on epidemiology, geriatric assessment as it relates to surgery and oncology, and the ability of older CRC patients to tolerate surgery, adjuvant chemotherapy, treatment of their metastatic disease including palliative chemotherapy with and without the use of the biologics, and finally the use of adjuvant and palliative radiotherapy in the treatment of older rectal cancer patients. An overview of each area was presented by one of the task force experts and comments invited from other task force members.
Collapse
Affiliation(s)
- D Papamichael
- Department of Medical Oncology, B.O. Cyprus Oncology Centre, Nicosia, Cyprus
| | | | - B Glimelius
- Department of Radiology, Oncology and Radiation Science, University of Uppsala, Uppsala, Sweden
| | | | | | - D Haller
- Abramson Cancer Center at the University of Pennsylvania, Philadelphia, USA
| | - C-H Köhne
- Klinikum Oldenburg, Oldenburg, Germany
| | - S Rostoft
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - V Lemmens
- Erasmus MC University Medical Centre, Rotterdam Eindhoven Cancer Registry, Comprehensive Cancer Centre South (IKZ), Eindhoven, The Netherlands
| | - E Mitry
- Department of Medical Oncology, Institut Curie, Paris Université Versailles Saint-Quentin, Guyancourt, France
| | - H Rutten
- Catharina Hospital Eindhoven, Eindhoven Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - J Sastre
- Department of Medical Oncology, Hospital Clinico San Carlos, Madrid, Spain
| | - M Seymour
- Cancer Medicine and Pathology, University of Leeds, Leeds
| | - N Starling
- Gastrointestinal Unit, Royal Marsden Hospital, London, UK
| | - E Van Cutsem
- Digestive Oncology, Leuven Cancer Institute, Leuven, Belgium
| | - M Aapro
- SIOG Office, Clinique de Genolier, Genolier, Switzerland
| |
Collapse
|
11
|
Kordatou Z, Kountourakis P, Papamichael D. Treatment of older patients with colorectal cancer: a perspective review. Ther Adv Med Oncol 2014; 6:128-40. [PMID: 24790652 PMCID: PMC3987654 DOI: 10.1177/1758834014523328] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
In a continuously aging population, the burden of colorectal cancer (CRC) is rising among older patients. Despite the fact that almost half of the cases occur in patients over 75 years, this age group is subjected to disparities regarding diagnostic and therapeutic options. So far, exclusion of older patients from randomized clinical trials has resulted in a lack of evidence-based guidelines. Nevertheless, newer data from studies specifically targeting older patients and subgroup analyses indicate that proper treatment planning and specific medical and geriatric assessment can achieve a safe and beneficial treatment result in older patients, often with similar outcomes to their younger counterparts. Resection of the primary tumour, if feasible, should be the primary goal of surgery aiming for cure, although it should be avoided under emergency conditions. Chronological age per se should not be an exclusion criterion for adjuvant or palliative chemotherapy, or targeted therapies. Careful patient selection, dose adjustments, close monitoring and early intervention in the event of side effects are essential. The benefits of treatment must be balanced with potential effects of treatment and patients' wishes.
Collapse
Affiliation(s)
- Z Kordatou
- Department of Medical Oncology, BOC Oncology Centre, Nicosia, Cyprus
| | - P Kountourakis
- Department of Medical Oncology, BOC Oncology Centre, Nicosia, Cyprus
| | | |
Collapse
|
12
|
Medarde-Ferrer M, Serra-Genís C, Roca J, Quer X, Sala F, Palau MA, Guixà M, de Cózar J, Molinas J, Tortras J, de Caralt E. Evaluación objetiva del grado de comorbilidad en pacientes geriátricos con neoplasia de colon: relación con los resultados quirúrgicos y la supervivencia. Cir Esp 2013; 91:231-6. [DOI: 10.1016/j.ciresp.2012.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 07/13/2012] [Accepted: 07/16/2012] [Indexed: 11/25/2022]
|