RESUMEN
OBJECTIVE: To explore the impact of postoperative recovery and short term quality of life in the patients with colorectal cancer in fast track model. METHODS: There were 122 patients enrolled into this prospective study in Gastrointestinal Surgery Center, West China Hospital of Sichuan University, from October 2008 to January 2009, and 121 patients completed the whole study. The patients were divided into the fast track group (62 cases) and the tradition track group (59 cases), postoperative recovery and the QLQ-C30 scores were evaluated at one week after the surgery. RESULTS: The fast track group showed earlier recovery than the tradition group in first aerofluxus [(3.96 +/- 1.40) d vs. (5.66 +/- 3.11) d, P < 0.05], first intake [(3.12 +/- 1.93) d vs. (5.96 +/- 3.23) d, P < 0.05], first ambulation [(2.05 +/- 1.16) d vs. (5.13 +/- 1.36) d, P < 0.05] and in-hospital time post-operation [(7.85 +/- 5.31) d vs. (10.11 +/- 3.37) d, P < 0.05]. The incidence of wound infection (1.61% vs. 6.78%, P < 0.05) and intestinal obstruction (1.61% vs. 8.47%, P < 0.05) in fast track were significantly lower than those in the traditional track group. The general health of fast track in C30 is better too (80.46 +/- 15.54 vs. 76.58 +/- 15.28, P < 0.05). In the functional assessment of C30, the physical function (87.35 +/- 5.12 vs. 85.02 +/- 8.70, P < 0.05) and emotional function (90.00 +/- 0.00 vs. 85.35 +/- 12.39, P < 0.05) both were better in the fast track group. In the symptom assessment of C30, fast track group is less fatigue (71.70 +/- 2.86 vs. 87.12 +/- 10.80, P < 0.05) and pain (71.78 +/- 3.76 vs. 77.63 +/- 8.33, P < 0.05). Better sleep (75.78 +/- 11.68 vs. 82.70 +/- 19.40, P < 0.05) and less loss of appetite(73.24 +/- 8.60 vs. 78.02 +/- 16.42, P < 0.05) were found in fast track group. CONCLUSION: The fast track group manifested faster in postoperative recovery and can improve the quality of life in postoperative patients with colorectal cancer.
Asunto(s)
Neoplasias Colorrectales/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Calidad de Vida , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To investigate the genetic polymorphisms of interleukin-1B (IL-1B) and interleukin-1 receptor antagonist gene (IL-1RN) in gastric cancer, and to explore the relationships of these genetic polymorphisms to the susceptibility of gastric cancer. METHODS: The polymorphisms of IL-1B and IL-1RN genes were analyzed by PCR-restriction fragment length polymorphism (PCR-RFLP) after extracting the genomic DNA from 140 gastric cancer patients and 165 age- and sex-matched healthy controls. RESULTS: The polymorphisms of IL-1B promoter region -31, -511 and +3954 locus have no significant difference between gastric cancer patients and healthy subjects. Four kinds of polymorphisms of IL-1RN were found as 2R/2R, 2R/4R, 3R/4R and 4R/4R, and the frequency in gastric cancer patients were 0.7%, 15.7%, 2.9% and 80.7%, respectively, while the frequency in healthy controls were 0, 5.5%, 0 and 94.5%, respectively. Compared to 4R/4R genotype, a 3.37 fold increased risk of gastric cancer were found in 2R/4R genotype, but the difference was not significant (P = 0.557, chi2 = 2.076). IL-1RN 2R allele frequencies in gastric cancer and healthy controls were 8.6% and 2.7%, respectively, which showed the risk to be gastric cancer increased 3.4 times, but the difference was not significant (P = 0.781, chi2 = 0.494). CONCLUSION: There is no evidence to support that the polymorphism of IL-1B and IL-1RN gene had relationship with gastric cancer. However, the risk of developing gastric cancer might be raised when the IL-1RN 2R allele exist.
Asunto(s)
Predisposición Genética a la Enfermedad/genética , Proteína Antagonista del Receptor de Interleucina 1/genética , Interleucina-1beta/genética , Neoplasias Gástricas/genética , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo GenéticoRESUMEN
OBJECTIVE: To assess the relationship between the incidence and prognostic significance of mesorectal involvement. METHODS: 328 cases of rectal cancer resected with total or subtotal mesorectal excision in our hospital from Jan. 1997 to Dec. 1998 were followed up and analyzed in this study. The neoplastic foci were identified at the pathologic examination of the mesorectum. RESULTS: Neoplastic mesorectal metastasis was found in 234 cases (71.3%); node involvement in 59.8% and microscopic foci involvement in 36% of all cases (isolated in 11.6%, microfoci alone without any kind of other mesorectal involvement). Microscopic deposits were found in 10.3% of TNM Stage I tumors, in 18.4% of Stage II and in 45.1% of Stage III cancers. Five-year disease-free survival rate (49.6% vs. 91.4%) were observed in patients with mesorectal involvement, compared with those without deposits. CONCLUSION: The incidence of neoplastic foci in the mesorectum seem to affect prognosis, even in early staged tumors. The presence of mesorectal foci should be considered an index in modifying the conventional staging of the rectal tumor.