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Impact of ileostomy in the adjuvant treatment and outcome of colon cancer
Background After tumor resection, a preventive diverting loop ileostomy creation is a routine surgical procedure to prevent anastomotic leakage and infections and to preclude secondary surgeries. Despite its benefits, several studies have proposed potential complications that extend the disease cour...
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| Published in: | International journal of colorectal disease 2023-06, Vol.38 (1), p.158-158, Article 158 |
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| container_end_page | 158 |
| container_issue | 1 |
| container_start_page | 158 |
| container_title | International journal of colorectal disease |
| container_volume | 38 |
| creator | Calderillo-Ruíz, Germán López-Basave, Horacio Noé Muñoz-Montaño, Wendy Rossemary Díaz-Romero, María Consuelo Carbajal-López, Berenice Castillo-Morales, Carolina Pérez-Yépez, Eloy Andrés Albarran-García, Alejandra |
| description | Background
After tumor resection, a preventive diverting loop ileostomy creation is a routine surgical procedure to prevent anastomotic leakage and infections and to preclude secondary surgeries. Despite its benefits, several studies have proposed potential complications that extend the disease course by impairing the feasibility of adjuvant chemotherapy and adherence.
Purpose
The aim of this study was to evaluate the impact of ileostomy complications on the adherence to adjuvant treatment and overall survival (OS) of colon cancer (CC) patients.
Methods
Retrospective, observational study. Patients diagnosed with colon adenocarcinoma were treated between January 2010 and December 2020 at the National Cancer Institute in Mexico.
Statistical analysis
χ
2
and
t
-test, Kaplan–Meier, log-rank, and Cox regression. Statistical significance differences were assessed when
p
was bilaterally |
| doi_str_mv | 10.1007/s00384-023-04421-w |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2821639659</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2821639659</sourcerecordid><originalsourceid>FETCH-LOGICAL-c457t-deb436b6a1c77292c543c55eb53548d0727f18591bdeb373cc2bba6197d2b2e43</originalsourceid><addsrcrecordid>eNp9kMtOwzAQRS0EoqXwAyxQlmwCfjtZoopHpUpsYG3ZjgOtErvYDlX_HpcUxIrVjDTnXmkOAJcI3iAIxW2EkFS0hJiUkFKMyu0RmCJKcIkwx8d_9gk4i3ENIRJc0FMwIQJzxEg1BYtFv1EmFb4tVp31Mfl-V6xckd5toZr18KlcKlKwKvU2b8o1hR-S8b3dR4zvvCuMcsaGc3DSqi7ai8OcgdeH-5f5U7l8flzM75aloUyksrGaEq65QkYIXGPDKDGMWc0Io1UDBRYtqliNdCaJIMZgrRVHtWiwxpaSGbgeezfBfww2JtmvorFdp5z1Q5S4woiTmrM6o3hETfAxBtvKTVj1KuwkgnKvUI4KZVYovxXKbQ5dHfoH3dvmN_LjLANkBGI-uTcb5NoPweWf_6v9AiqtfGg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2821639659</pqid></control><display><type>article</type><title>Impact of ileostomy in the adjuvant treatment and outcome of colon cancer</title><source>Springer Link</source><creator>Calderillo-Ruíz, Germán ; López-Basave, Horacio Noé ; Muñoz-Montaño, Wendy Rossemary ; Díaz-Romero, María Consuelo ; Carbajal-López, Berenice ; Castillo-Morales, Carolina ; Pérez-Yépez, Eloy Andrés ; Albarran-García, Alejandra</creator><creatorcontrib>Calderillo-Ruíz, Germán ; López-Basave, Horacio Noé ; Muñoz-Montaño, Wendy Rossemary ; Díaz-Romero, María Consuelo ; Carbajal-López, Berenice ; Castillo-Morales, Carolina ; Pérez-Yépez, Eloy Andrés ; Albarran-García, Alejandra</creatorcontrib><description>Background
After tumor resection, a preventive diverting loop ileostomy creation is a routine surgical procedure to prevent anastomotic leakage and infections and to preclude secondary surgeries. Despite its benefits, several studies have proposed potential complications that extend the disease course by impairing the feasibility of adjuvant chemotherapy and adherence.
Purpose
The aim of this study was to evaluate the impact of ileostomy complications on the adherence to adjuvant treatment and overall survival (OS) of colon cancer (CC) patients.
Methods
Retrospective, observational study. Patients diagnosed with colon adenocarcinoma were treated between January 2010 and December 2020 at the National Cancer Institute in Mexico.
Statistical analysis
χ
2
and
t
-test, Kaplan–Meier, log-rank, and Cox regression. Statistical significance differences were assessed when
p
was bilaterally < 0.05.
Results
The most frequent complications of loop-derived ileostomy were hydro-electrolytic dehydration (50%), acute kidney injury (AKI) (26%), grade 1–2 diarrhea (28%), and grade 3–4 diarrhea (21%) (
p
= 0.001). Patients with complete chemotherapy did not reach the median OS. In contrast, the median OS for patients with non-complete chemotherapy was 56 months (
p
= 0.023). Additionally, 5-year OS reached to 100% in the early restitution group, 85% in the late restitution group, and 60% in the non-restitution group (
p
= 0.016). Finally, AKI (
p
= 0.029; 95% confidence interval (CI) 3.348 [1.133–9.895]), complete chemotherapy (
p
= 0.028; 95% CI 0.376 [0.105–0.940]), and reversed ileostomy (
p
= 0.001; 95% CI 0.125 [0.038–0.407]) remained as predictors of overall survival for patients with CC treated with a loop ileostomy.
Conclusions
Our results emphasize the early stoma reversal restitution as a safe and feasible alternative to prevent severe complications related to ileostomies which improve chemotherapy adherence and overall survival of colon cancer patients. This is one of the pioneer studies analyzing the impact of ileostomy on treatment adherence and outcome of Latin American patients with colon cancer.
Trial registration
Retrospective study No. 2021/045, in April 2021.</description><identifier>ISSN: 1432-1262</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-023-04421-w</identifier><identifier>PMID: 37261538</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Gastroenterology ; Hepatology ; Internal Medicine ; Medicine ; Medicine & Public Health ; Proctology ; Surgery</subject><ispartof>International journal of colorectal disease, 2023-06, Vol.38 (1), p.158-158, Article 158</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c457t-deb436b6a1c77292c543c55eb53548d0727f18591bdeb373cc2bba6197d2b2e43</citedby><cites>FETCH-LOGICAL-c457t-deb436b6a1c77292c543c55eb53548d0727f18591bdeb373cc2bba6197d2b2e43</cites><orcidid>0000-0001-7929-0175</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37261538$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Calderillo-Ruíz, Germán</creatorcontrib><creatorcontrib>López-Basave, Horacio Noé</creatorcontrib><creatorcontrib>Muñoz-Montaño, Wendy Rossemary</creatorcontrib><creatorcontrib>Díaz-Romero, María Consuelo</creatorcontrib><creatorcontrib>Carbajal-López, Berenice</creatorcontrib><creatorcontrib>Castillo-Morales, Carolina</creatorcontrib><creatorcontrib>Pérez-Yépez, Eloy Andrés</creatorcontrib><creatorcontrib>Albarran-García, Alejandra</creatorcontrib><title>Impact of ileostomy in the adjuvant treatment and outcome of colon cancer</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Background
After tumor resection, a preventive diverting loop ileostomy creation is a routine surgical procedure to prevent anastomotic leakage and infections and to preclude secondary surgeries. Despite its benefits, several studies have proposed potential complications that extend the disease course by impairing the feasibility of adjuvant chemotherapy and adherence.
Purpose
The aim of this study was to evaluate the impact of ileostomy complications on the adherence to adjuvant treatment and overall survival (OS) of colon cancer (CC) patients.
Methods
Retrospective, observational study. Patients diagnosed with colon adenocarcinoma were treated between January 2010 and December 2020 at the National Cancer Institute in Mexico.
Statistical analysis
χ
2
and
t
-test, Kaplan–Meier, log-rank, and Cox regression. Statistical significance differences were assessed when
p
was bilaterally < 0.05.
Results
The most frequent complications of loop-derived ileostomy were hydro-electrolytic dehydration (50%), acute kidney injury (AKI) (26%), grade 1–2 diarrhea (28%), and grade 3–4 diarrhea (21%) (
p
= 0.001). Patients with complete chemotherapy did not reach the median OS. In contrast, the median OS for patients with non-complete chemotherapy was 56 months (
p
= 0.023). Additionally, 5-year OS reached to 100% in the early restitution group, 85% in the late restitution group, and 60% in the non-restitution group (
p
= 0.016). Finally, AKI (
p
= 0.029; 95% confidence interval (CI) 3.348 [1.133–9.895]), complete chemotherapy (
p
= 0.028; 95% CI 0.376 [0.105–0.940]), and reversed ileostomy (
p
= 0.001; 95% CI 0.125 [0.038–0.407]) remained as predictors of overall survival for patients with CC treated with a loop ileostomy.
Conclusions
Our results emphasize the early stoma reversal restitution as a safe and feasible alternative to prevent severe complications related to ileostomies which improve chemotherapy adherence and overall survival of colon cancer patients. This is one of the pioneer studies analyzing the impact of ileostomy on treatment adherence and outcome of Latin American patients with colon cancer.
Trial registration
Retrospective study No. 2021/045, in April 2021.</description><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Proctology</subject><subject>Surgery</subject><issn>1432-1262</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kMtOwzAQRS0EoqXwAyxQlmwCfjtZoopHpUpsYG3ZjgOtErvYDlX_HpcUxIrVjDTnXmkOAJcI3iAIxW2EkFS0hJiUkFKMyu0RmCJKcIkwx8d_9gk4i3ENIRJc0FMwIQJzxEg1BYtFv1EmFb4tVp31Mfl-V6xckd5toZr18KlcKlKwKvU2b8o1hR-S8b3dR4zvvCuMcsaGc3DSqi7ai8OcgdeH-5f5U7l8flzM75aloUyksrGaEq65QkYIXGPDKDGMWc0Io1UDBRYtqliNdCaJIMZgrRVHtWiwxpaSGbgeezfBfww2JtmvorFdp5z1Q5S4woiTmrM6o3hETfAxBtvKTVj1KuwkgnKvUI4KZVYovxXKbQ5dHfoH3dvmN_LjLANkBGI-uTcb5NoPweWf_6v9AiqtfGg</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Calderillo-Ruíz, Germán</creator><creator>López-Basave, Horacio Noé</creator><creator>Muñoz-Montaño, Wendy Rossemary</creator><creator>Díaz-Romero, María Consuelo</creator><creator>Carbajal-López, Berenice</creator><creator>Castillo-Morales, Carolina</creator><creator>Pérez-Yépez, Eloy Andrés</creator><creator>Albarran-García, Alejandra</creator><general>Springer Berlin Heidelberg</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7929-0175</orcidid></search><sort><creationdate>20230601</creationdate><title>Impact of ileostomy in the adjuvant treatment and outcome of colon cancer</title><author>Calderillo-Ruíz, Germán ; López-Basave, Horacio Noé ; Muñoz-Montaño, Wendy Rossemary ; Díaz-Romero, María Consuelo ; Carbajal-López, Berenice ; Castillo-Morales, Carolina ; Pérez-Yépez, Eloy Andrés ; Albarran-García, Alejandra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c457t-deb436b6a1c77292c543c55eb53548d0727f18591bdeb373cc2bba6197d2b2e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Proctology</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Calderillo-Ruíz, Germán</creatorcontrib><creatorcontrib>López-Basave, Horacio Noé</creatorcontrib><creatorcontrib>Muñoz-Montaño, Wendy Rossemary</creatorcontrib><creatorcontrib>Díaz-Romero, María Consuelo</creatorcontrib><creatorcontrib>Carbajal-López, Berenice</creatorcontrib><creatorcontrib>Castillo-Morales, Carolina</creatorcontrib><creatorcontrib>Pérez-Yépez, Eloy Andrés</creatorcontrib><creatorcontrib>Albarran-García, Alejandra</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Calderillo-Ruíz, Germán</au><au>López-Basave, Horacio Noé</au><au>Muñoz-Montaño, Wendy Rossemary</au><au>Díaz-Romero, María Consuelo</au><au>Carbajal-López, Berenice</au><au>Castillo-Morales, Carolina</au><au>Pérez-Yépez, Eloy Andrés</au><au>Albarran-García, Alejandra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of ileostomy in the adjuvant treatment and outcome of colon cancer</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>38</volume><issue>1</issue><spage>158</spage><epage>158</epage><pages>158-158</pages><artnum>158</artnum><issn>1432-1262</issn><eissn>1432-1262</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>ObjectType-Undefined-3</notes><abstract>Background
After tumor resection, a preventive diverting loop ileostomy creation is a routine surgical procedure to prevent anastomotic leakage and infections and to preclude secondary surgeries. Despite its benefits, several studies have proposed potential complications that extend the disease course by impairing the feasibility of adjuvant chemotherapy and adherence.
Purpose
The aim of this study was to evaluate the impact of ileostomy complications on the adherence to adjuvant treatment and overall survival (OS) of colon cancer (CC) patients.
Methods
Retrospective, observational study. Patients diagnosed with colon adenocarcinoma were treated between January 2010 and December 2020 at the National Cancer Institute in Mexico.
Statistical analysis
χ
2
and
t
-test, Kaplan–Meier, log-rank, and Cox regression. Statistical significance differences were assessed when
p
was bilaterally < 0.05.
Results
The most frequent complications of loop-derived ileostomy were hydro-electrolytic dehydration (50%), acute kidney injury (AKI) (26%), grade 1–2 diarrhea (28%), and grade 3–4 diarrhea (21%) (
p
= 0.001). Patients with complete chemotherapy did not reach the median OS. In contrast, the median OS for patients with non-complete chemotherapy was 56 months (
p
= 0.023). Additionally, 5-year OS reached to 100% in the early restitution group, 85% in the late restitution group, and 60% in the non-restitution group (
p
= 0.016). Finally, AKI (
p
= 0.029; 95% confidence interval (CI) 3.348 [1.133–9.895]), complete chemotherapy (
p
= 0.028; 95% CI 0.376 [0.105–0.940]), and reversed ileostomy (
p
= 0.001; 95% CI 0.125 [0.038–0.407]) remained as predictors of overall survival for patients with CC treated with a loop ileostomy.
Conclusions
Our results emphasize the early stoma reversal restitution as a safe and feasible alternative to prevent severe complications related to ileostomies which improve chemotherapy adherence and overall survival of colon cancer patients. This is one of the pioneer studies analyzing the impact of ileostomy on treatment adherence and outcome of Latin American patients with colon cancer.
Trial registration
Retrospective study No. 2021/045, in April 2021.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37261538</pmid><doi>10.1007/s00384-023-04421-w</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-7929-0175</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| subjects | Gastroenterology Hepatology Internal Medicine Medicine Medicine & Public Health Proctology Surgery |
| title | Impact of ileostomy in the adjuvant treatment and outcome of colon cancer |
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