Estimation of Physiologic Ability and Surgical Stress for Neoadjuvant Chemotherapy on Postoperative Risk of Colorectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SHAO Na ^1,2,3 , TANG Zhiyun ^1,2,3 , HUANG Libing ^1,2,3 , WU Ting ^1,2,3 , WANG Xiaodong ^1,2 , LI Li ^1,2

1. Center of Gastrointestinal Surgery， West China Hospital， Sichuan University， Chengdu 610041， Sichuan Province，China;;
2. West China Hospital MCQ Team， Sichuan University， Chengdu 610041， Sichuan Province， China;;
3. West China Medical School， Sichuan University， Chengdu 610041， Sichuan Province， China;

Corresponding author：

Keywords：

Estimation of physiologic ability and surgical stress; Neoadjuvant chemotherapy; Colorectal cancer; Complications

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To explore the effectiveness of neoadjuvant chemotherapy on postoperative risk of colorectal cancer by use of estimation of physiologic ability and surgical stress （E-PASS）.
Methods 　A total of 161 patients with colorectal cancer according to the inclusion criteria from January 2009 to December 2009 in West China Hospital of Sichuan University were analyzed retrospectively，who were assigned to neoadjuvant chemotherapy group （NC group, 78 patients） and non-NC group （83 patients）. The postoperative risk of each group was assessed by the E-PASS scale including preoperative risk score （PRS），surgical stress score （SSS），and comprehensive risk score （CRS）.
Results 　The baseline of two groups had no significant difference （P＞0.05）. The postoperative complication incidence of two groups had no significant difference either （P＞0.05）， which was 10.26% （8/78） in the NC group，and 7.23% （6/83） in the non-NC group. The PRS was 78.42 in the NC group and 83.42 in the non-NC group （P=0.497）. The SSS was 80.77 in the NC group and 81.22 in the non-NC group （P=0.951）. The CRS was 80.74 in the NC group and 81.24 in the non-NC group （P=0.976）. The accuracy of the postoperative risk assessment was 70 cases and 78 cases in the NC group and non-NC group，respectively. There was no significant difference of accuracy between two groups （P=0.325）.
Conclusions 　Neoadjuvant chemotherapy does not increase the risk of patients with colorectal cancer after operation，and the results suggest that E-PASS scale can provide a more accurate assessment of neoadjuvant chemotherapy in patients with surgical risk.

Citation： SHAO Na,TANG Zhiyun,HUANG Libing,WU Ting,WANG Xiaodong,LI Li,.. Estimation of Physiologic Ability and Surgical Stress for Neoadjuvant Chemotherapy on Postoperative Risk of Colorectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(5): 517-521. doi: Copy

1.	汪晓东，曹霖，吕东昊，等. 多学科协作诊治模式下结直肠癌新辅助化疗联合手术的风险评估研究 [J]. 中国普外基础与临床杂志， 2008， 15(9)：692-696.
2.	汪晓东，曾天芳，曹霖，等. 多学科协作诊治模式下新辅助化疗干预结直肠癌手术方案的临床研究 [J]. 中国普外基础与临床杂志， 2008， 15(6)：451-454.
3.	Haga Y， Ikei S， Wada Y， et al. Evaluation of an estimation of physiologic ability and surgical stress (E-PASS) scoring system to predict postoperative risk：a multicenter prospective study [J].Surg Today， 2001， 31(7)：569-574.
4.	Haga Y， Ikei S， Ogawa M. Estimation of physiologic ability and surgical stress (E-PASS) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery [J]. Surg Today， 1999， 29(3)：219-225.
5.	Haga Y， Wada Y， Takeuchi H， et al. Estimation of surgical costs using a prediction scoring system：estimation of physiologic ability and surgical stress [J]. Arch Surg， 2002， 137(4)：481-485.
6.	Haga Y， Wada Y， Takeuchi H， et al. Estimation of physiologic ability and surgical stress (E-PASS) for a surgical audit in elective digestive surgery [J]. Surgery， 2004， 135(6)：586-594.
7.	Hirose J， Mizuta H， Ide J， et al. Evaluation of estimation of physiologic ability and surgical stress (E-PASS) to predict the postoperative risk for hip fracture in elder patients [J]. Arch Orthop Trauma Surg， 2008， 128(12)：1447-1452.
8.	Tang T， Walsh SR， Fanshawe TR， et al. Estimation of physiologic ability and surgical stress (E-PASS) as a predictor of immediate outcome after elective abdominal aortic aneurysm surgery [J]. Am J Surg， 2007， 194(2)：176-182.
9.	Sobin LH， Fleming ID. TNM Classification of Malignant Tumors，fifth edition (1997). Union Internationale Contre le Cancer and the American Joint Committee on Cancer [J]. Cancer，1997， 80(9)：1803-1804.
10.	AJCC Cancer Staging Manual. TNM classification of malignant tumors[M]. 7th edition. New York：Springer， 2009：REC-3-REF-9.
11.	Folprecht G， Grothey A， Alberts S， et al. Neoadjuvant treatment of unresectable colorectal liver metastases：correlation between tumour response and resection rates [J]. Ann Oncol， 2005，16(8)：1311-1319.
12.	Guillem JG， Chessin DB， Cohen AM， et al. Long-term oncologic outcome following preoperative combined modality therapy and total mesorectal excision of locally advanced rectal cancer [J].Ann Surg， 2005， 241(5)：829-836.
13.	Gentile M， Bucci L， Cerbone D， et al. Evaluation of downstaging as leading concept in sphincter-saving surgery for rectal cancer after preoperative radio-chemotherapy (Preop RCT) [J]. Ann Ital Chir， 2003， 74(5)：555-558.
14.	Minsky BD. Adjuvant therapy for rectal cancer － the transatlantic view [J]. Colorectal Dis， 2003， 5(5)：416-422.
15.	Feliu J， Calvilio J， Escribano A， et al. Neoadjuvant therapy of rectal carcinoma with UFT-leucovorin plus radiotherapy [J].Ann Oncol， 2002， 13(5)：730-736.
16.	Kienle P， Koch M， Autschbach F， et al. Decreased detection rate of disseminated tumor cells of rectal cancer patients after preoperative chemoradiation：a first step towards a molecular surrogate marker for neoadjuvant treatment in colorectal cancer [J].Ann Surg， 2003， 238(3)：324-330.
17.	Tekkis PP， Poloniecki JD， Thompson MR， et al. Operative mortality in colorectal cancer：prospective national study [J]. BMJ，2003， 327(7425)：1196-1201.
18.	Chao MW， Tjandra JJ， Gibbs P， et al. How safe is adjuvant chemotherapy and radiotherapy for rectal cancer? [J]. Asian J Surg， 2004， 27(2)：147-161.
19.	Buie WD， Maclean AR， Attard JA， et al. Neoadjuvant chemoradiation increases the risk of pelvic sepsis after radical excision of rectal cancer [J]. Dis Colon Rectum， 2005， 48(10)：1868-1874.
20.	Glynne-Jones R， Harrison M. Locally advanced rectal cancer：what is the evidence for induction chemoradiation? [J]. Oncologist，2007， 12(11)：1309-1318.
21.	Metcalfe MS， Norwood MG， Miller AS， et al. Unreasonable expectations in emergency colorectal cancer surgery [J]. Colorectal Dis， 2005， 7(3)：275-278.

1. 汪晓东，曹霖，吕东昊，等. 多学科协作诊治模式下结直肠癌新辅助化疗联合手术的风险评估研究 [J]. 中国普外基础与临床杂志， 2008， 15(9)：692-696.
2. 汪晓东，曾天芳，曹霖，等. 多学科协作诊治模式下新辅助化疗干预结直肠癌手术方案的临床研究 [J]. 中国普外基础与临床杂志， 2008， 15(6)：451-454.
3. Haga Y， Ikei S， Wada Y， et al. Evaluation of an estimation of physiologic ability and surgical stress (E-PASS) scoring system to predict postoperative risk：a multicenter prospective study [J].Surg Today， 2001， 31(7)：569-574.
4. Haga Y， Ikei S， Ogawa M. Estimation of physiologic ability and surgical stress (E-PASS) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery [J]. Surg Today， 1999， 29(3)：219-225.
5. Haga Y， Wada Y， Takeuchi H， et al. Estimation of surgical costs using a prediction scoring system：estimation of physiologic ability and surgical stress [J]. Arch Surg， 2002， 137(4)：481-485.
6. Haga Y， Wada Y， Takeuchi H， et al. Estimation of physiologic ability and surgical stress (E-PASS) for a surgical audit in elective digestive surgery [J]. Surgery， 2004， 135(6)：586-594.
7. Hirose J， Mizuta H， Ide J， et al. Evaluation of estimation of physiologic ability and surgical stress (E-PASS) to predict the postoperative risk for hip fracture in elder patients [J]. Arch Orthop Trauma Surg， 2008， 128(12)：1447-1452.
8. Tang T， Walsh SR， Fanshawe TR， et al. Estimation of physiologic ability and surgical stress (E-PASS) as a predictor of immediate outcome after elective abdominal aortic aneurysm surgery [J]. Am J Surg， 2007， 194(2)：176-182.
9. Sobin LH， Fleming ID. TNM Classification of Malignant Tumors，fifth edition (1997). Union Internationale Contre le Cancer and the American Joint Committee on Cancer [J]. Cancer，1997， 80(9)：1803-1804.
10. AJCC Cancer Staging Manual. TNM classification of malignant tumors[M]. 7th edition. New York：Springer， 2009：REC-3-REF-9.
11. Folprecht G， Grothey A， Alberts S， et al. Neoadjuvant treatment of unresectable colorectal liver metastases：correlation between tumour response and resection rates [J]. Ann Oncol， 2005，16(8)：1311-1319.
12. Guillem JG， Chessin DB， Cohen AM， et al. Long-term oncologic outcome following preoperative combined modality therapy and total mesorectal excision of locally advanced rectal cancer [J].Ann Surg， 2005， 241(5)：829-836.
13. Gentile M， Bucci L， Cerbone D， et al. Evaluation of downstaging as leading concept in sphincter-saving surgery for rectal cancer after preoperative radio-chemotherapy (Preop RCT) [J]. Ann Ital Chir， 2003， 74(5)：555-558.
14. Minsky BD. Adjuvant therapy for rectal cancer － the transatlantic view [J]. Colorectal Dis， 2003， 5(5)：416-422.
15. Feliu J， Calvilio J， Escribano A， et al. Neoadjuvant therapy of rectal carcinoma with UFT-leucovorin plus radiotherapy [J].Ann Oncol， 2002， 13(5)：730-736.
16. Kienle P， Koch M， Autschbach F， et al. Decreased detection rate of disseminated tumor cells of rectal cancer patients after preoperative chemoradiation：a first step towards a molecular surrogate marker for neoadjuvant treatment in colorectal cancer [J].Ann Surg， 2003， 238(3)：324-330.
17. Tekkis PP， Poloniecki JD， Thompson MR， et al. Operative mortality in colorectal cancer：prospective national study [J]. BMJ，2003， 327(7425)：1196-1201.
18. Chao MW， Tjandra JJ， Gibbs P， et al. How safe is adjuvant chemotherapy and radiotherapy for rectal cancer? [J]. Asian J Surg， 2004， 27(2)：147-161.
19. Buie WD， Maclean AR， Attard JA， et al. Neoadjuvant chemoradiation increases the risk of pelvic sepsis after radical excision of rectal cancer [J]. Dis Colon Rectum， 2005， 48(10)：1868-1874.
20. Glynne-Jones R， Harrison M. Locally advanced rectal cancer：what is the evidence for induction chemoradiation? [J]. Oncologist，2007， 12(11)：1309-1318.
21. Metcalfe MS， Norwood MG， Miller AS， et al. Unreasonable expectations in emergency colorectal cancer surgery [J]. Colorectal Dis， 2005， 7(3)：275-278.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Estimation of Physiologic Ability and Surgical Stress for Neoadjuvant Chemotherapy on Postoperative Risk of Colorectal Cancer

Abstract Full text Figures/Tables Video References Cited by

Format

Content