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Intraoperative Blood Loss Independently Predicts Survival and Recurrence after Resection of Colorectal Cancer Liver Metastasis

BACKGROUND: Although numerous prognostic factors have been reported for colorectal cancer liver metastasis (CRLM), few studies have reported intraoperative blood loss (IBL) effects on clinical outcome after CRLM resection. METHODS: We retrospectively evaluated the clinical and histopathological char...

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Autores principales: Jiang, Wu, Fang, Yu-Jing, Wu, Xiao-Jun, Wang, Fu-Long, Lu, Zhen-Hai, Zhang, Rong-Xin, Ding, Pei-Rong, Fan, Wen-Hua, Pan, Zhi-Zhong, De-Sen Wan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788029/
https://www.ncbi.nlm.nih.gov/pubmed/24098431
http://dx.doi.org/10.1371/journal.pone.0076125
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author Jiang, Wu
Fang, Yu-Jing
Wu, Xiao-Jun
Wang, Fu-Long
Lu, Zhen-Hai
Zhang, Rong-Xin
Ding, Pei-Rong
Fan, Wen-Hua
Pan, Zhi-Zhong
De-Sen Wan,
author_facet Jiang, Wu
Fang, Yu-Jing
Wu, Xiao-Jun
Wang, Fu-Long
Lu, Zhen-Hai
Zhang, Rong-Xin
Ding, Pei-Rong
Fan, Wen-Hua
Pan, Zhi-Zhong
De-Sen Wan,
author_sort Jiang, Wu
collection PubMed
description BACKGROUND: Although numerous prognostic factors have been reported for colorectal cancer liver metastasis (CRLM), few studies have reported intraoperative blood loss (IBL) effects on clinical outcome after CRLM resection. METHODS: We retrospectively evaluated the clinical and histopathological characteristics of 139 patients who underwent liver resection for CRLM. The IBL cutoff volume was calculated using receiver operating characteristic curves. Overall survival (OS) and recurrence free survival (RFS) were assessed using the Kaplan–Meier and Cox regression methods. RESULTS: All patients underwent curative resection. The median follow up period was 25.0 months (range, 2.1–88.8). Body mass index (BMI) and CRLM number and tumor size were associated with increased IBL. BMI (P=0.01; 95% CI = 1.3–8.5) and IBL (P<0.01; 95% CI = 1.6–12.5) were independent OSOs predictors. Five factors, including IBL (P=0.02; 95% CI = 1.1–4.1), were significantly related to RFS via multivariate Cox regression analysis. In addition, OSOs and RFS significantly decreased with increasing IBL volumes. The 5-year OSOs of patients with IBL≤250, 250–500, and >500mL were 71%, 33%, and 0%, respectively (P<0.01). RFS of patients within three IBL volumes at the end of the first year were 67%, 38%, and 18%, respectively (P<0.01). CONCLUSIONS: IBL during CRLM resection is an independent predictor of long term survival and tumor recurrence, and its prognostic value was confirmed by a dose–response relationship.
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spelling pubmed-37880292013-10-04 Intraoperative Blood Loss Independently Predicts Survival and Recurrence after Resection of Colorectal Cancer Liver Metastasis Jiang, Wu Fang, Yu-Jing Wu, Xiao-Jun Wang, Fu-Long Lu, Zhen-Hai Zhang, Rong-Xin Ding, Pei-Rong Fan, Wen-Hua Pan, Zhi-Zhong De-Sen Wan, PLoS One Research Article BACKGROUND: Although numerous prognostic factors have been reported for colorectal cancer liver metastasis (CRLM), few studies have reported intraoperative blood loss (IBL) effects on clinical outcome after CRLM resection. METHODS: We retrospectively evaluated the clinical and histopathological characteristics of 139 patients who underwent liver resection for CRLM. The IBL cutoff volume was calculated using receiver operating characteristic curves. Overall survival (OS) and recurrence free survival (RFS) were assessed using the Kaplan–Meier and Cox regression methods. RESULTS: All patients underwent curative resection. The median follow up period was 25.0 months (range, 2.1–88.8). Body mass index (BMI) and CRLM number and tumor size were associated with increased IBL. BMI (P=0.01; 95% CI = 1.3–8.5) and IBL (P<0.01; 95% CI = 1.6–12.5) were independent OSOs predictors. Five factors, including IBL (P=0.02; 95% CI = 1.1–4.1), were significantly related to RFS via multivariate Cox regression analysis. In addition, OSOs and RFS significantly decreased with increasing IBL volumes. The 5-year OSOs of patients with IBL≤250, 250–500, and >500mL were 71%, 33%, and 0%, respectively (P<0.01). RFS of patients within three IBL volumes at the end of the first year were 67%, 38%, and 18%, respectively (P<0.01). CONCLUSIONS: IBL during CRLM resection is an independent predictor of long term survival and tumor recurrence, and its prognostic value was confirmed by a dose–response relationship. Public Library of Science 2013-10-01 /pmc/articles/PMC3788029/ /pubmed/24098431 http://dx.doi.org/10.1371/journal.pone.0076125 Text en © 2013 Jiang et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Jiang, Wu
Fang, Yu-Jing
Wu, Xiao-Jun
Wang, Fu-Long
Lu, Zhen-Hai
Zhang, Rong-Xin
Ding, Pei-Rong
Fan, Wen-Hua
Pan, Zhi-Zhong
De-Sen Wan,
Intraoperative Blood Loss Independently Predicts Survival and Recurrence after Resection of Colorectal Cancer Liver Metastasis
title Intraoperative Blood Loss Independently Predicts Survival and Recurrence after Resection of Colorectal Cancer Liver Metastasis
title_full Intraoperative Blood Loss Independently Predicts Survival and Recurrence after Resection of Colorectal Cancer Liver Metastasis
title_fullStr Intraoperative Blood Loss Independently Predicts Survival and Recurrence after Resection of Colorectal Cancer Liver Metastasis
title_full_unstemmed Intraoperative Blood Loss Independently Predicts Survival and Recurrence after Resection of Colorectal Cancer Liver Metastasis
title_short Intraoperative Blood Loss Independently Predicts Survival and Recurrence after Resection of Colorectal Cancer Liver Metastasis
title_sort intraoperative blood loss independently predicts survival and recurrence after resection of colorectal cancer liver metastasis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788029/
https://www.ncbi.nlm.nih.gov/pubmed/24098431
http://dx.doi.org/10.1371/journal.pone.0076125
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