• Title/Summary/Keyword: preoperative

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Prognostic Significance of Preoperative Anemia, Leukocytosis and Thrombocytosis in Chinese Women with Epithelial Ovarian Cancer

  • Chen, Ying;Zhang, Lei;Liu, Wen-Xin;Liu, Xiang-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.933-939
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    • 2015
  • Malignant tumors are often accompanied by increased risk of hematological abnormalities. However, few studies have reported any prognostic impact of preoperative thrombocytosis, leukocytosis and anemia in epithelia ovarian cancer (EOC). This study aimed to investigate preoperative hematological parameters for anemia, leukocytosis and thombocytosis in relation to established prognostic factors and survival in EOC cases. A total of 816 Chinese women treated for EOC were retrospectively included in the study focusing on the relationship between preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathologic characteristics and outcome. Preoperative anemia was present in 13.4%, leukocytosis in 16.7% and thrombocytosis in 22.8%. Additionally, EOC patients with low differentiation grade, advanced stage, lymph node (LN) metastasis, residual disease ${\geq}1cm$, ascites volume >1,000ml, serum cancer antigen 125 (CA125) >675U/ml, and disease recurrence had the higher prevalence of preoperative anemia, leukocytosis and thrombocytosis (all p<0.05). Moreover, EOC patients with older age or postmenopausal EOC patients had the higher prevalence of thrombocytosis (28.7% vs 17.3% or 26.0% vs 17.7%). Furthermore, in a Cox proportional hazard model, thrombocytosis was an independent factor for progression-free survival (PFS) and overall survival (OS) (p<0.001). Conclusively, preoperative anemia, leukocytosis or thrombocytosis in EOC patients is closely associated with more malignant disease phenotype and poorer prognosis. Significantly, thrombocytosis may independently predict the disease-specific survival for EOC patients.

A LATERAL CEPHALOMETRIC STUDY OF POSTOPERATIVE OCCLUSAL PLANE ALTERATION OF SKELETAL CLASS III MALOCCLUSION PATIENT (골격성 3급 부정교합자의 술후 교합평면의 변화에 관한 연구 (측모두부방사선 규격사진계측을 중심으로))

  • 박규태;이상철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.1
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    • pp.25-34
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    • 1997
  • This study was made with lateral cephalometric radiography of 28 skeletal class III malocclusion patients that were performed to setback surgery of mandible. The 28 patients were selected by four standards as follows. 1) Set-back amount of mandible is below 10 mm 2) No extrusion and intrusion of posterior tooth or alteration of interincisial angle at period of postoperative orthodontic treatment. 3) Change of mesial segment location of mandible on lateral cephalometrics 4) No genioplasty And 28 patients were divided to three group(1,2,3 group) by degree of preoperative occlusal plane angle to Burstone's horizontal plane. The preoperative occlusal plane angle, which of 1 group was smaller than $7^{\circ}$ and 2 group was between $7^{\circ}$ to $15^{\circ}$ and 3 group was larger than $15^{\circ}$. The results were as follows : 1. As the preoperative occlusal plane angle was larger, the degree of mandibular prognathism was not severe. 2. On comparsion of preoperative and immediate postoperative cephalometric analysis, specific relationship of occlusal plane angle and set-back amount of mandible was not present. 3. As the preoperative occlusal plane angle was smaller, the alteration of postoperative occlusal plane angle was increased tendency. As the preoperative occlusal plane angle was larger, the alteration of postoperative occlusal plane angle was decreased tendency. 4. The relapsed degree of B point distance to Vertical plane was not relationship to the degree of preoperative occlusal plane angle.

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The Neutrophil-to-Lymphocyte Ratio as a Predictor of Postoperative Outcomes in Patients Undergoing Coronary Artery Bypass Grafting

  • Hyun Ah Lim;Joon Kyu Kang;Hwan Wook Kim;Hyun Son;Ju Yong Lim
    • Journal of Chest Surgery
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    • v.56 no.2
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    • pp.99-107
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    • 2023
  • Background: The neutrophil-to-lymphocyte ratio (NLR) has been suggested as a novel predictive marker of cardiovascular disease. However, its prognostic role in patients under-going coronary artery bypass grafting (CABG) is unclear. This study aimed to determine the association between the preoperative NLR and early mortality in patients undergoing CABG. Methods: Cardiac surgery was performed in 2,504 patients at Seoul St. Mary's Hospital from January 2010 to December 2021. This study retrospectively reviewed 920 patients who underwent isolated CABG, excluding those for whom the preoperative NLR was unavailable. The primary endpoints were the 30- and 90-day mortality after isolated CABG. Risk factor analysis was performed using logistic regression analysis. Based on the optimal cut-off value of preoperative NLR on the receiver operating characteristic curve, high and low NLR groups were compared. Results: The 30- and 90-day mortality rates were 3.8% (n=35) and 7.0% (n=64), respectively. In the multivariable analysis, preoperative NLR was significantly associated with 30-day mortality (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.17-1.39; p<0.001) and 90-day mortality (OR, 1.17; 95% CI, 1.07-1.28; p<0.001). The optimal cut-off value of the preoperative NLR was 3.4. Compared to the low NLR group (<3.4), the high NLR group (≥3.4) showed higher 30- and 90-day mortality rates (1.4% vs. 12.1%, p<0.001; 2.8% vs. 21.3%, p<0.001, respectively). Conclusion: Preoperative NLR was strongly associated with early mortality after isolated CABG, especially in patients with a high preoperative NLR (≥3.4). Further studies with larger cohorts are necessary to validate these results.

Preoperative Long Course Chemoirradiation in a Developing Country for Rectal Carcinoma: Kuala Lumpur Hospital Experience

  • Lee, Wei Ching;Yusof, Mastura Md.;Lau, Fen Nee;Ee Phua, Vincent Chee
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3941-3944
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    • 2013
  • Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.

The Impact of Preoperative Chemotherapy on the Surgical Management of Unresectable Gastric Cancer (수술 전 항암요법이 절제 불가능한 위암 환자의 수술에 미치는 영향)

  • Yoon, Sam-Youl;Kim, Min-Gyu;Oh, Sung-Tae
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.269-274
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    • 2009
  • Purpose: There have been reported that preoperative chemotherapy for treating noncurative gastric cancer could increase the R0 resection rate by downstaging the gastric cancer. Yet there have been only rare reports about the effect of preoperative chemotherapy on performing surgery for noncurative gastric cancer. Our study was designed to analyze our experiences with these effects. Materials and Methods: We retrospectively analyzed 46 patients who had undergone gastrectomy after chemotherapy between December 2001 and January 2009. The patients' preoperative condition, the operative findings and the postoperative clinical coursed were analyzed. Results: Preoperative chemotherapy was performed for a mean of 4.4 cycles. Four patients showed a level of ANC below 1,500 (${\mu}/L$) and above a 10 percentile weight loss, respectively. For an operation, we found fibrosis or fixation between the tumor and the adjacent organs in 29 patients, and 4 of the 13 patients who underwent resection with another organ were documented to have invasion by tumor. Forty one patients underwent curative resection. Ten patients developed postoperative complications. There was no mortality at postoperative 60 days. Conclusion: We assumed that preoperative chemotherapy had little effect on the patient preoperatively, and it had some effect on down-staging pathologically. Preoperative chemotherapy didn't increase the postoperative complication rate.

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THE USEFULNESS OF BONE SCAN FOR EVALUATING JAW BONE EXTENSION OF ORAL CANCER (구강암의 악골 침윤 평가에 있어서 골스캔의 효과)

  • Park, Hong-Ju;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.658-665
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    • 2000
  • Purpose : The present study was carried out to determine the diagnostic usefulness of bone scan for evaluating jaw bone extension of oral cancer. Materials and Methods : Medical records, preoperative bone scans, computerized tomographic (CT) scans, conventional radiographs, and findings of histopathologic sections of twenty patients who had been treated for oral malignant tumors by a resection of mandible and soft tissue at Chonnam University Hospital from January, 1994 to September, 1999 were analyzed. Results : In 13 cases which showed histopathologically positive, preoperative bone scans were positive in 12 (92.3%) and false negative in 1 (7.7%). Preoperative CT scans were positive in 9 (69.2%) and false negative in 4 (30.8%) of the 13 cases. Preoperative conventional radiographs were positive in 8 (61.5%) and false negative in 5 (38.5%) of the 13 cases. In 7 cases showing negative histopathologic findings, 1 (14.3%) was in CT scans and 2 (28.6%) were false positive in preoperative conventional radiographs. Conclusion : These results suggest that bone scan is more sensitive and reliable method for evaluating jaw bone extension of oral cancer than conventional radiographs or CT scans.

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The Effects of Aromatherapy Hands Massage on the Preoperative Anxiety of Stomach Cancer Patients (아로마테라피 손 마사지가 위암환자의 수술 전 불안에 미치는 효과)

  • Sung, Mi Hae;Lee, Seung Ae;Sim, Jeong Sun
    • Korean Journal of Adult Nursing
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    • v.18 no.5
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    • pp.709-717
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    • 2006
  • Purpose: The Purpose of this study was to elucidate the effects of aromatherapy massage on the preoperative anxiety of stomach cancer patients. Method: The research design was a nonequivalent control group non synchronized design. The data were collected during the period of October 2 to December 30, 2005 at H Hospital in Seoul. The subjects were 40 patients who were operated under general anesthesia for stomach cancer. State anxiety, systolic and diastolic blood pressure, pulse rate were measured on the day before surgery and the preoperative period. Data were analyzed by ${\chi}^2$ test, independent t-test, paired t-test. Results: Hypothesis 1 that the level of preoperative state anxiety of the experimental group who received aromatherapy massage is lower than that of the control group who did not received aromatherapy was supported(p=.004). Hypothesis 2 the physiological index of the preoperative anxiety of the experimental group who received aromatherapy is lower than that of the control group who did not received aromatherapy. Conclusion: According to these results, aromatherapy hand massage can be regarded as a partially effective nursing intervention that relives anxiety of surgical patients and decreases the blood pressure level.

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Effect of Preoperative Education using Multimedia on Pain, Uncertainty, Anxiety and Depression in Hysterectomy Patients (동영상을 이용한 수술 전 교육이 양성종양 자궁절제술 환자의 통증, 불확실성, 불안과 우울에 미치는 효과)

  • Jeon, Sooran;Park, Hyojung
    • Women's Health Nursing
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    • v.22 no.1
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    • pp.39-47
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    • 2016
  • Purpose: The purpose of this study was to examine the effect of preoperative education using multimedia on level of pain, uncertainty, anxiety and depression in hysterectomy patients. Methods: A non-equivalent control group, with a pretest-posttest design was used in this study. The level of post operation pain, pre and post operation uncertainty, anxiety and depression of both the groups was measured. The experimental group was provided with preoperative education using multimedia on the preoperative day at the hospital. The control group was only given usual care. Data were analyzed using SPSS/WIN version 22.0 program. Results: Experimental group showed lower level of post-operation pain in 1 hour (t=-5.08, p<.001) and 24 hours (t=-5.20, p<.001) but not 48 hours (t=-0.91, p=.368). Uncertainty showed significant interaction effect of Group by Time (F=4.16, p=.018). Conclusion: Preoperative education using multimedia for patients with hysterectomy would be effective in lowering patients' level of pain, uncertainty, anxiety and depression.

The Effect of Education on Preoperative PCA upon Postoperative Pain (수술 전 통증자가조절기에 관한 교육이 수술 후 통증에 미치는 효과)

  • Seo, Hyo-Shin;Park, Kyung-Sook
    • Korean Journal of Adult Nursing
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    • v.14 no.3
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    • pp.449-458
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    • 2002
  • Purpose: The purpose of this study was to compare the effectiveness of a structured preoperative PCA education to that of the usual informal teaching provided by hospital staff in alleviating postoperative pain through more effective use of PCA therapy. Method: As an advanced research, the knowledge about the use of PCA therapy and the attitude about the use of the pain medicine were estimated, and then as a later research, the knowledge about the use of PCA therapy, the attitude about the use of the pain medicine, and the score of the pain were estimated. Result: The experimental group those who received structured preoperative PCA education had statistically significant higher knowledge regarding the use of PCA therapy(p=0.026) and more positive attitudes toward using pain medicine(p=0.004). The experimental group those who received structured preoperative PCA education reported better pain control 4(p=0.002), 8(p=0.014) and 24 hours(p=0.018) after the operation. Conclusion: The structured preoperative PCA education increases the knowledge for the use of patient's PCA therapy and changes their attitude toward the use of the pain medicine positively and consequently enable the use of PCA therapy to be more effective and then finally reduced the patient's pain after the operation.

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Prognostic role of preoperative carcinoembryonic antigen levels in colorectal cancer: propensity score matching

  • Kim, Cho Shin;Kim, Sohyun
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.216-221
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    • 2017
  • Background: This study was conducted to investigate preoperative carcinoembryonic antigen (CEA) as a prognostic factor in colorectal cancer. Methods: Between January 2000 and July 2011, 1298 patients with primary adenocarcinoma colorectal cancer without metastasis, who underwent curative resection were retrospectively identified. The patients were divided into two groups according to serum CEA level at primary diagnosis: a high CEA (HCEA) group (serum CEA ${\geq}6ng/mL$) and a normal CEA (NCEA) group (serum CEA <6 ng/mL). A 1:1 propensity score matching analysis was applied to reduce bias. Finally, 364 patients were enrolled in this study. Matched variables were age, gender, preoperative chemoradiotherapy, tumor site, cell differentiation and pathologic stage. Results: The clinicopathological characteristics of the two groups did not differ significantly difference. The systemic metastasis rate was 16.5% (30/182) and 25.3% (46/182) in the NCEA and HCEA groups, respectively (p=0.039). There were no significant differences in local recurrence or metastatic sites between groups. The 5-year disease-free survival (DFS) rate of the HCEA group was worse than that of the NCEA group; however, there was no significant difference in overall survival between the two groups. Conclusion: Elevated preoperative CEA was related to frequent systemic recurrence and low DFS. Therefore, elevated preoperative CEA could be considered a prognostic factor for worse clinical outcomes in patients with colorectal cancer.