1
|
Serban AM, Ionescu NS. Surgical patient registries: scoping study of challenges and solutions. J Public Health Policy 2023; 44:523-534. [PMID: 37726394 DOI: 10.1057/s41271-023-00442-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/21/2023]
Abstract
Patient surgical registries are essential tools for public health specialists, creating research opportunities through linkage of registry data with healthcare outcomes. However, little is known regarding data error sources in the management of surgical registries. In June 2022, we undertook a scoping study of the empirical literature including publications selected from the PUBMED and EMBASE databases. We selected 48 studies focussing on shared experiences centred around developing surgical patient registries. We identified seven types of data specific challenges, grouped in three categories- data capture, data analysis and result dissemination. Most studies underlined the risk for a high volume of missing data, non-uniform geographic representation, inclusion biases, inappropriate coding, as well as variations in analysis reporting and limitations related to the statistical analysis. Finally, to expand data usability, we discussed cost-effective ways of addressing these limitations, by citing aspects from the protocols followed by established exemplary registries.
Collapse
Affiliation(s)
- Andreea Madalina Serban
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474, Bucharest, Romania.
- Maria Sklodowska Curie Emergency Hospital for Children, 20 Brancoveanu Blvd., 077120, Bucharest, Romania.
| | - Nicolae Sebastian Ionescu
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474, Bucharest, Romania
- Maria Sklodowska Curie Emergency Hospital for Children, 20 Brancoveanu Blvd., 077120, Bucharest, Romania
| |
Collapse
|
2
|
Yu Q, Wang X, Yang Y, Chi P, Huang J, Qiu S, Zheng X, Chen X. Upregulated NLGN1 predicts poor survival in colorectal cancer. BMC Cancer 2021; 21:884. [PMID: 34340665 PMCID: PMC8327451 DOI: 10.1186/s12885-021-08621-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/16/2021] [Indexed: 12/14/2022] Open
Abstract
Background Neuroligin1 (NLGN1) is a main component of excitatory glutamatergic synapses complex and is important for synapse assembly and function. The clinical value of NLGN1 in colorectal cancer (CRC) is not clear. Methods We obtained the expression data of 1143 CRC patients from 3 independent Gene Expression Omnibus (GEO) datasets (GSE32323, GSE24551, GSE39582) and The Cancer Genome Atlas (TCGA) to make the comparison of the NLGN1 expression level between CRC tissues and matched noncancerous tissues, and to evaluate its value in predicting survival of CRC patients. At the protein level, these results were further confirmed by immunohistochemical staining of 52 CRC samples in our own centre. Finally, the function of NLGN1 was explored by gene set enrichment analysis (GSEA). Results Increased mRNA and protein levels of NLGN1 expression were associated with worse overall survival or recurrence-free survival in CRC patients from 2 GEO datasets, the TCGA database, and our cohort. In addition, multivariate regression analysis showed that NLGN1 was an independent poor prognostic factor of survival in patients with CRC in TCGA database (OR = 2.524, P = 0.010). Functional analysis revealed that NLGN1 was correlated with function involving the Hedgehog signaling pathway, mismatch repair process, and some material metabolism processes. Conclusions This study is the first to implicate and verify NLGN1 as a new poor prognostic marker for CRC.
Collapse
Affiliation(s)
- Qian Yu
- Department of Pathology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, Fujian, 350001, People's Republic of China
| | - Xiaojie Wang
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, Fujian, 350001, People's Republic of China.
| | - Yinghong Yang
- Department of Pathology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, Fujian, 350001, People's Republic of China.
| | - Pan Chi
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, Fujian, 350001, People's Republic of China
| | - Jianping Huang
- Department of Pathology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, Fujian, 350001, People's Republic of China
| | - Shengliang Qiu
- Department of Pathology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, Fujian, 350001, People's Republic of China
| | - Xin Zheng
- Department of Pathology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, Fujian, 350001, People's Republic of China
| | - Xiaowen Chen
- Department of Pathology, Union Hospital, Fujian Medical University, 29 Xin-Quan Road, Fuzhou, Fujian, 350001, People's Republic of China
| |
Collapse
|
3
|
En-Bloc Resection of Metastases of the Proximal Femur and Reconstruction by Modular Arthroplasty is Not Only Justified in Patients with a Curative Treatment Option-An Observational Study of a Consecutive Series of 45 Patients. J Clin Med 2020; 9:jcm9030758. [PMID: 32168829 PMCID: PMC7141379 DOI: 10.3390/jcm9030758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/01/2020] [Accepted: 03/06/2020] [Indexed: 11/16/2022] Open
Abstract
Background: There is little conformity regarding the surgical treatment of metastasis of the proximal femur, especially in palliative patients with limited life expectancy. Patients and Methods: En-bloc resection of secondary bone malignancies of the proximal femur and reconstruction by modular arthroplasty was performed in a consecutive series of 45 patients. The mean follow-up period was 16.4 months (0.6–74.7). Results: The survival rate of all patients was 6.6% (95% CI: 0–14.9) at 74.7 months. There was no significant difference in patients with a solitary or disseminated disease at index operation (log-rank p = 0.1214). Recurrent dislocation was the most frequent local complication (n = 6) necessitating an open reduction in four cases. The use of a Trevira tube showed a higher risk of dislocation compared to the simple bonding of remaining soft tissue (6 out of 28 vs. 0 out of 17; Fisher test: p = 0.0463). The worst-case survival rate with the removal of the arthroplasty for any cause and/or loss to follow-up was 80.0% (95% CI: 44.9–100) at 74.7 months (n = 1 due to low-grade infection). Conclusions: En-bloc resection of metastases and reconstruction by modular arthroplasty is reliable even in patients with very limited life expectancy. Local complications due to tumor growth or instability after intralesional surgery could be managed successfully but recurrent dislocation as the most frequent complication has to be taken into account. The simple bonding of remaining soft tissue around the prosthesis without the use of an attachment tube may reduce the dislocation rate and reoperation risk.
Collapse
|
4
|
Sterpetti AV, Costi U, D'Ermo G. National statistics about resection of the primary tumor in asymptomatic patients with Stage IV colorectal cancer and unresectable metastases. Need for improvement in data collection. A systematic review with meta-analysis. Surg Oncol 2019; 33:11-18. [PMID: 31885359 DOI: 10.1016/j.suronc.2019.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/25/2019] [Accepted: 12/18/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Patients with asymptomatic Stage IV colorectal cancer represent a significant heterogeneous group. National statistics represent an effective method to follow in real time the clinical outcomes of patients, and they may represent an important tool to analyze and to compare different therapeutic approaches. The aim of our study was to analyze the reviews of national data and single institutions reports, which compared the clinical outcomes of patients with asymptomatic Stage IV colorectal cancer and un-resectable metastases who had resection of the primary tumor with those who did not have resection. We gave special attention to the number of missing established relevant variables, to determine the appropriateness of the results of the published studies. MATERIAL We performed a systematic review of papers comparing patients who had and who had not primary tumor resection. Screened reports included the time of publication from June 2012 to June 2018; 2556 papers were identified and 27 were included into the review. The primary outcome was observed survival. We analyzed the number of major missing variables in National Data Bases and Single Institution Reports, to assess the overall validity of the conclusions of the analyzed reports. RESULTS In the majority of the reports and in the meta-analysis of studies with propensity score matching, resection of the primary tumor was correlated to improved survival and to the possibility for a better response to postoperative chemotherapy. CONCLUSIONS The high number of missing significant variables, and a clear clinical selection in single center reports make any analysis error-prone. National statistics might represent a valid method to follow in real time the clinical outcomes of these patients, comparing different therapeutic approaches. There is the need for improvement in national data collection, to make descriptive national statistics the ground for future progress in treatment. (PROSPERO) CRD 42018089691.
Collapse
|
5
|
Pule ML, Buckley E, Niyonsenga T, Roder D. The effects of comorbidity on colorectal cancer mortality in an Australian cancer population. Sci Rep 2019; 9:8580. [PMID: 31189947 PMCID: PMC6561932 DOI: 10.1038/s41598-019-44969-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 05/29/2019] [Indexed: 01/18/2023] Open
Abstract
This study estimated the absolute risk of colorectal cancer (CRC) specific and other-cause mortality using data from the population-based South Australian Cancer Registry. The impact of competing risks on the absolute and relative risks of mortality in cases with and without comorbidity was also investigated. The study included 7115 staged, primary CRC cases diagnosed between 2003 and 2012 with at least one year of follow-up. Comorbidities were classified according to Charlson, Elixhauser and C3 comorbidity indices, using hospital inpatient diagnoses occurring five years before CRC diagnosis. To estimate the differences in measures of association, the subdistribution hazard ratios (sHR) for the effect of comorbidity on mortality from the Fine and Gray model were compared to the cause-specific hazards (HR) from Cox regression model. CRC was most commonly diagnosed in people aged ≧ 70 years. In cases without comorbidity, the 10-year cumulative probability of CRC and other cause mortality were 37.1% and 17.2% respectively. In cases with Charlson comorbidity scores ≥2, the 10-year cumulative probability of CRC-specific and other cause mortality was 45.5% and 32.2%, respectively. Comorbidity was associated with increased CRC-specific and other cause mortality and the effect differed only marginally based on comorbidity index used.
Collapse
Affiliation(s)
- Maleshwane Lettie Pule
- Cancer Epidemiology and Population Health Group, University of South Australia Cancer Research Institute, Adelaide, SA, 5001, Australia.
| | - Elizabeth Buckley
- Cancer Epidemiology and Population Health Group, University of South Australia Cancer Research Institute, Adelaide, SA, 5001, Australia
| | - Theophile Niyonsenga
- Cancer Epidemiology and Population Health Group, University of South Australia Cancer Research Institute, Adelaide, SA, 5001, Australia
- Centre for Research and Action in Public Health, University of Canberra, University Drive, Bruce, ACT, 2617, Australia
| | - David Roder
- Cancer Epidemiology and Population Health Group, University of South Australia Cancer Research Institute, Adelaide, SA, 5001, Australia
| |
Collapse
|
6
|
Lund T. Treatment Opportunities for Colorectal Liver Metastases. EUROPEAN MEDICAL JOURNAL 2016. [DOI: 10.33590/emj/10311794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Colorectal liver metastases (CLM) are the most common hepatic malignancy and are caused by disseminated tumour cells (DTCs) seeded early in the tumourigenesis of colorectal cancer. Despite optimal treatment, CLM are associated with high mortality rates. This review provides an overview of three promising strategies to extend survival in CLM: treatment of DTCs, immunotherapy, and new surgical resection techniques.
Collapse
Affiliation(s)
- Tormod Lund
- Surgical Department, Vestre Viken Hospital Trust, Drammen, Norway
| |
Collapse
|