AIM： To determine the effect of body mass index （BMI） on the characteristics and overall outcome of colon cancer in Taiwan. METHODS： From January 1995 to July 2003, 2138 patients with colon cancer were enrolled in...AIM： To determine the effect of body mass index （BMI） on the characteristics and overall outcome of colon cancer in Taiwan. METHODS： From January 1995 to July 2003, 2138 patients with colon cancer were enrolled in this study. BMI categories （in kg/m2） were established according to the classification of the Department of Health of Tai- wan. Postoperative morbidities and mortality, and survival analysis including overall survival （OS）, disease- free survival （DFS）, and cancer-specific survival （CSS） were compared across the BMI categories.27 kg/m2） patients. Being female, apparently anemic, hypoalbuminemic, and having body weight loss was more likely among underweight patients than among the other patients （P 〈 0.001）. Underweight patients had higher mortality rate （P = 0.00.7） and lower OS （P 〈 0.001） and DFS （P = 0.002） than the other pa- tients. OS and DFS did not differ significantly between normal-weight, overweight, and obese patients, while CSS did not differ significantly with the BMI category. CONCLUSION： In Taiwan, BMI does not significantly affect colon-CSS. Underweight patients had a higher rate of surgical mortality and a worse OS and DFS than the other patients. Obesity does not predict a worse survival.展开更多
AIM:To describe a condition that we define as early graft dysfunction(EGD)which can be identified preoperatively. METHODS:Small-for-size graft dysfunction following living-related liver transplantation(LRLT)is charact...AIM:To describe a condition that we define as early graft dysfunction(EGD)which can be identified preoperatively. METHODS:Small-for-size graft dysfunction following living-related liver transplantation(LRLT)is characterized by EGD when the graft-to-recipient body weight ratio(GRBWR)is below 0.8%.However, patients transplanted with GRBWR above 0.8%can develop dysfunction of the graft.In 73 recipients of LRLT(GRBWR>0.8%),we identified 10 patients who developed EGD.The main measures of outcomes analyzed were overall mortality,number of re-transplants and length of stay in days(LOS).Furthermore we analyzed other clinical pre-transplant variables,intraoperative parameters and post transplant data.RESULTS:A trend in favor of the non-EGD group(3-mo actuarial survival 98%vs 88%,P=0.09;3-mo graft mortality 4.7%vs 20%,P=0.07)was observed as well as shorter LOS(13 d vs 41.5 d;P=0.001)and smaller requirement of peri-operative Units of Plasma (4 vs 14;P=0.036).Univariate analysis of pre- transplant variables identified platelet count,serum bilirubin,INR and Meld-Na score as predictors of EGD. In the multivariate analysis transplant Meld-Na score (P=0.025,OR:1.175)and pretransplant platelet count(P=0.043,OR:0.956)were independently associated with EGD. CONCLUSION:EGD can be identified preoperatively and is associated with increased morbidity after LRLT. A prompt recognition of EGD can trigger a timely treatment.展开更多
Objective:Knowledge about the impact of metabolic disturbances and parenteral nutrition(PN)characteristics on the survival of cancer patients receiving PN is limited.We aimed to assess the association between clinical...Objective:Knowledge about the impact of metabolic disturbances and parenteral nutrition(PN)characteristics on the survival of cancer patients receiving PN is limited.We aimed to assess the association between clinical and PN characteristics and survival in colorectal-cancer patients receiving PN support.Methods:Our study included 572 consecutive colorectal-cancer patients who had received PN support between 2008 and 2013.Patient characteristics,body mass index,weight,medical/surgical history,indication for PN,PN data and survival were recorded.Associations between clinical and PN characteristics and survival were analysed with important confounding factors.Results:The final cohort included 437 evaluable patients,with a mean age of 57 years.Eighty-one percent of the study population had advanced stage of colorectal cancer.Unstable weight(weight change≥2.5%)prior to PN initiation[hazard ratio(HR)=1.41,P=0.023]was adversely associated with survival after adjusting for multiple factors including cancer stage.Bowel obstruction(HR=1.75,P=0.017)as a PN indication was associated with worse survival when compared with without bowel obstruction.Higher PN amino acid by ideal body weight(g•kg^(-1))(HR=0.59,P=0.029)was associated with longer survival,whereas a higher percentage of non-PN intravenous calories(HR=1.04,P=0.011)was associated with shorter survival independently of confounding factors.Conclusions:Body mass index and weight stability can be useful nutritional indices for survival prediction in cancer patients receiving PN.PN planning should take into account of non-PN calories to achieve optimal energy support and balance.Future research is needed to define optimal PN amino-acid requirement and energy balance.展开更多
文摘AIM： To determine the effect of body mass index （BMI） on the characteristics and overall outcome of colon cancer in Taiwan. METHODS： From January 1995 to July 2003, 2138 patients with colon cancer were enrolled in this study. BMI categories （in kg/m2） were established according to the classification of the Department of Health of Tai- wan. Postoperative morbidities and mortality, and survival analysis including overall survival （OS）, disease- free survival （DFS）, and cancer-specific survival （CSS） were compared across the BMI categories.27 kg/m2） patients. Being female, apparently anemic, hypoalbuminemic, and having body weight loss was more likely among underweight patients than among the other patients （P 〈 0.001）. Underweight patients had higher mortality rate （P = 0.00.7） and lower OS （P 〈 0.001） and DFS （P = 0.002） than the other pa- tients. OS and DFS did not differ significantly between normal-weight, overweight, and obese patients, while CSS did not differ significantly with the BMI category. CONCLUSION： In Taiwan, BMI does not significantly affect colon-CSS. Underweight patients had a higher rate of surgical mortality and a worse OS and DFS than the other patients. Obesity does not predict a worse survival.
文摘AIM:To describe a condition that we define as early graft dysfunction(EGD)which can be identified preoperatively. METHODS:Small-for-size graft dysfunction following living-related liver transplantation(LRLT)is characterized by EGD when the graft-to-recipient body weight ratio(GRBWR)is below 0.8%.However, patients transplanted with GRBWR above 0.8%can develop dysfunction of the graft.In 73 recipients of LRLT(GRBWR>0.8%),we identified 10 patients who developed EGD.The main measures of outcomes analyzed were overall mortality,number of re-transplants and length of stay in days(LOS).Furthermore we analyzed other clinical pre-transplant variables,intraoperative parameters and post transplant data.RESULTS:A trend in favor of the non-EGD group(3-mo actuarial survival 98%vs 88%,P=0.09;3-mo graft mortality 4.7%vs 20%,P=0.07)was observed as well as shorter LOS(13 d vs 41.5 d;P=0.001)and smaller requirement of peri-operative Units of Plasma (4 vs 14;P=0.036).Univariate analysis of pre- transplant variables identified platelet count,serum bilirubin,INR and Meld-Na score as predictors of EGD. In the multivariate analysis transplant Meld-Na score (P=0.025,OR:1.175)and pretransplant platelet count(P=0.043,OR:0.956)were independently associated with EGD. CONCLUSION:EGD can be identified preoperatively and is associated with increased morbidity after LRLT. A prompt recognition of EGD can trigger a timely treatment.
基金The University of Texas MD Anderson Cancer Center was supported in part by the NIH through Cancer Center Support Grant P30 CA016672.
文摘Objective:Knowledge about the impact of metabolic disturbances and parenteral nutrition(PN)characteristics on the survival of cancer patients receiving PN is limited.We aimed to assess the association between clinical and PN characteristics and survival in colorectal-cancer patients receiving PN support.Methods:Our study included 572 consecutive colorectal-cancer patients who had received PN support between 2008 and 2013.Patient characteristics,body mass index,weight,medical/surgical history,indication for PN,PN data and survival were recorded.Associations between clinical and PN characteristics and survival were analysed with important confounding factors.Results:The final cohort included 437 evaluable patients,with a mean age of 57 years.Eighty-one percent of the study population had advanced stage of colorectal cancer.Unstable weight(weight change≥2.5%)prior to PN initiation[hazard ratio(HR)=1.41,P=0.023]was adversely associated with survival after adjusting for multiple factors including cancer stage.Bowel obstruction(HR=1.75,P=0.017)as a PN indication was associated with worse survival when compared with without bowel obstruction.Higher PN amino acid by ideal body weight(g•kg^(-1))(HR=0.59,P=0.029)was associated with longer survival,whereas a higher percentage of non-PN intravenous calories(HR=1.04,P=0.011)was associated with shorter survival independently of confounding factors.Conclusions:Body mass index and weight stability can be useful nutritional indices for survival prediction in cancer patients receiving PN.PN planning should take into account of non-PN calories to achieve optimal energy support and balance.Future research is needed to define optimal PN amino-acid requirement and energy balance.
