Ghrelin's second life - World Journal of Gastroenterology

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indicate a later timing for radical resection. The early radical resection group had an advantage of a shorter hospital stay with no difference in terms of complications comparing to the late group. Applications Earlier oral feeding, presence of bowel sound, passage of flatus and removal of the nasogastric tube, which indicating recovery of bowel function, seem to be predictive factors for early radical resection in two-staged resection for obstructive CRC. Peer review This paper describes two-stage resection for acute left-sided malignant colonic obstructions: timing of early radical resection and possible predictive factors. This work provides useful information on the early group had significantly earlier presence of bowel sounds, flatus, and removal of nasogastric tube and resumption of oral feeding. REFERENCES 1 Welch JP, Donaldson GA. Management of severe obstruction of the large bowel due to malignant disease. Am J Surg 1974; 127: 492–499 2 Ohman U. Prognosis in patients with obstructing colorectal carcinoma. Am J Surg 1982; 143: 742–747 3 Umpleby HC, Williamson RC. Survival in acute obstructing colorectal carcinoma. Dis Colon Rectum 1984; 27: 299–304 4 Phillips RK, Hittinger R, Fry JS, Fielding LP. Malignant large bowel obstruction. Br J Surg 1985; 72: 296-302 5 Mulcahy HE, Skelly MM, Husain A, O’Donoghue DP. Long-term outcome following curative surgery for malignant large bowel obstruction. Br J Surg 1996; 83: 46-50 6 Runkel NS, Hinz U, Lehnert T, Buhr HJ, Herfarth Ch. Improved outcome after emergency surgery for cancer of the large intestine. Br J Surg 1998; 85: 1260-1265 7 Chen HS, Sheen-Chen SM. Obstruction and perforation in colorectal adenocarcinoma: an analysis of prognosis and current trends. Surgery 2000; 127: 370-376 8 Lee YM, Law WL, Chu KW, Poon RT. Emergency surgery for obstructing colorectal cancers: a comparison between right-sided and left-sided lesions. J Am Coll Surg 2001; 192: 719–725 9 Jiang JK, Lan YT, Lin TC, Chen WS, Yang SH, Wang HS, Chang SC, Lin JK. Primary vs. delayed resection for obstructive left-sided colorectal cancer: impact of surgery on patient outcome. Dis Colon Rectum 2008; 51: 306-311 10 Runkel NS, Schlag P, Schwarz V, Herfarth C. Outcome after emergency surgery for cancer of the large intestine. Br J Surg 1991; 78: 183-188 11 De Salvo GL, Gava C, Pucciarelli S, Lise M. Curative surgery for obstruction from primary left colorectal carcinoma: WJG|www.wjgnet.com Yang HY et al . Early resection of obstructive colon cancer primary or staged resection? Cochrane Database Syst Rev 2004; CD002101 12 Carty NJ, Corder AP. Which surgeons avoid a stoma in treating left-sided colonic obstruction? Results of a postal questionnaire. Ann R Coll Surg Engl 1992; 74: 391-394 13 Kronborg O. [Acute colonic ileus caused by left-sided colorectal cancer. A randomized trial of emergency ostomy versus resection]. Ugeskr Laeger 1995; 157: 5858-5861 14 Nemes R, Vasile I, Curca T, Paraliov T, Pasalega M, Mesina C, Dinca N, Valcea D. Acute bowel obstruction - the main complication of colorectal cancer. Therapeutical options. Rom J Gastroenterol 2004; 13: 109-112 15 Caiazzo P, Di Palma R, Pesce G, Pede A. [Obstructing colon cancer--what’s the surgical strategy?]. Ann Ital Chir 2004; 75: 455-460 16 Cuffy M, Abir F, Audisio RA, Longo WE. Colorectal cancer presenting as surgical emergencies. Surg Oncol 2004; 13: 149-157 17 Lopez-Kostner F, Hool GR, Lavery IC. Management and causes of acute large-bowel obstruction. Surg Clin North Am 1997; 77: 1265–1290 18 Isbister WH, Prasad J. Emergency large bowel surgery: a 15-year audit. Int J Colorectal Dis 1997; 12: 285-290 19 Parc R, Bouteloup PY, Kartheuser A. [Must we reject primary colostomy in left colonic obstruction caused by cancer?]. Chirurgie 1989; 115 Suppl 2: 112-116 20 Corman ML. Chapter 22: Carcinoma of the Colon. In: Colon and rectal surgery. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2005: 845 21 Cugnenc PH, Berger A, Zinzindohoue F, Quinaux D, Wind P, Chevallier JM. [2-stage surgery of neoplastic left colonic obstruction remains the safest procedure]. J Chir (Paris) 1997; 134: 275–278 22 Bresler L, Braun E, Debs A, Boissel P, Grosdidier J. [Emergency surgery in colonic obstructions. Retrospective study of 70 cases]. J Chir (Paris) 1986; 123: 713–718 23 Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003; 31: 1250-1256 24 Sobin LH, Fleming ID. TNM classification of malignant tumors. 5th ed. Union Internationale Contre le Cancer and the American Joint Committee on Cancer. Cancer 1997; 80: 1803– 1804 25 Finan PJ, Campbell S, Verma R, MacFie J, Gatt M, Parker MC, Bhardwaj R, Hall NR. The management of malignant large bowel obstruction: ACPGBI position statement. Colorectal Dis 2007; 9 Suppl 4: 1-17 26 Ripamonti CI, Easson AM, Gerdes H. Management of malignant bowel obstruction. Eur J Cancer 2008; 44: 1105-1115 S-Editor Cheng JX L-Editor O’Neill M E-Editor Zhang DN 3271 July 7, 2012|Volume 18|Issue 25|
Online Submissions: http://www.wjgnet.com/1007-9327office wjg@wjgnet.com doi:10.3748/wjg.v18.i25.3272 Preoperative predictors of short-term survival after hepatectomy for multinodular hepatocellular carcinoma Wen-Chao Zhao, Hai-Bin Zhang, Ning Yang, Yong Fu, Wei Qian, Ben-Dong Chen, Lu-Feng Fan, Guang-Shun Yang Wen-Chao Zhao, Hai-Bin Zhang, Ning Yang, Yong Fu, Ben- Dong Chen, Lu-Feng Fan, Guang-Shun Yang, Fifth Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China Wei Qian, Department of Health Statistics, Second Military Medical University, Shanghai 200433, China Author contributions: Zhao WC and Zhang HB contributed equally to this work; Zhao WC and Zhang HB performed the majority of the research and wrote the paper; Yang N, Fu Y, Fan LF and Chen BD contributed to acquisition of data; Zhao WC and Qian W analyzed the data; Yang GS designed the research and critically revised the draft for important intellectual content; Zhao WC and Zhang HB contributed equally to this work. Correspondence to: Dr. Guang-Shun Yang, Professor, Fifth Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225 Changhai Road, Shanghai 200438, China. dreamcatcher919@gmail.com Telephone: +86-21-81875292 Fax: +86-21-81875291 Received: October 14, 2011 Revised: March 21, 2012 Accepted: April 22, 2012 Published online: July 7, 2012 Abstract AIM: To investigate preoperative factors associated with poor short-term outcome after resection for multinodular hepatocellular carcinoma (HCC) and to assess the contraindication of patients for surgery. METHODS: We retrospectively analyzed 162 multinodular HCC patients with Child-Pugh A liver function who underwent surgical resection. The prognostic significance of preoperative factors was investigated by univariate analysis using the log-rank test and by multivariate analysis using the Cox proportional hazards model. Each independent risk factor was then assigned points to construct a scoring model to evaluate the indication for surgical intervention. A receiver operating characteristics (ROC) curve was constructed to assess the predictive ability of this system. WJG|www.wjgnet.com World J Gastroenterol 2012 July 7; 18(25): 3272-3281 ISSN 1007-9327 (print) ISSN 2219-2840 (online) © 2012 Baishideng. All rights reserved. RESULTS: The median overall survival was 38.3 mo (range: 3-80 mo), while the median disease-free survival was 18.6 mo (range: 1-79 mo). The 1-year mortality was 14%. Independent prognostic risk factors of 1-year death included prealbumin < 170 mg/L [hazard ratio (HR): 5.531, P < 0.001], alkaline phosphatase > 129 U/L (HR: 3.252, P = 0.005), α fetoprotein > 20 μg/L (HR: 7.477, P = 0.011), total tumor size > 8 cm (HR: 10.543; P < 0.001), platelet count < 100 × 10 9 /L (HR: 9.937, P < 0.001), and γ-glutamyl transpeptidase > 64 U/L (HR: 3.791, P < 0.001). The scoring model had a strong ability to predict 1-year survival (area under ROC: 0.925, P < 0.001). Patients with a score ≥ 5 had significantly poorer short-term outcome than those with a score < 5 (1-year mortality: 62% vs 5%, P < 0.001; 1-year recurrence rate: 86% vs 33%, P < 0.001). Patients with score ≥ 5 had greater possibility of microvascular invasion (P < 0.001), poor tumor differentiation (P = 0.003), liver cirrhosis with small nodules (P < 0.001), and intraoperative blood transfusion (P = 0.010). CONCLUSION: A composite preoperative scoring model can be used as an indication of prognosis of HCC patients after surgical resection. Resection should be considered with caution in patients with a score ≥ 5, which indicates a contraindication for surgery. © 2012 Baishideng. All rights reserved. BRIEF ARTICLE Key words: Hepatectomy; Hepatocellular carcinoma; Multinodular; Prognosis; Treatment outcome Peer reviewers: Dr. Silvio Nadalin, General Surgery and Transplantation, University Hospital Tuebingen, 72076 Tuebingen, Germany; Dr. Kaye M Reid Lombardo, General Surgery, Mayo Clinic, 200 First St. SW, Rochester, MI 55905, United States; Dr. Masayuki Ohta, Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Oita 879-5593, Japan; Kenji Miki, MD, Department of Surgery, Showa General Hospital, 2-450 Tenjin-cho, Tokyo 187-8510, Japan 3272 July 7, 2012|Volume 18|Issue 25|
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World Journal of Gastroenterology W
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Phillip S Oates, Perth Ross C Smith
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Deepak N Amarapurkar, Mumbai Abhiji
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Trine Olsen, Tromsø Eyvind J Pauls
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Conor P Delaney, Cleveland Sharon D
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S Contents EDITORIAL TOPIC HIGHLIGH
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Contents ACKNOWLEDGMENTS APPENDIX A
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Verhulst PJ et al . Ghrelin and glu
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Online Submissions: http://www.wjgn
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Ishikawa T. Zinc during interferon
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Sitarz R et al . Gastroenterostoma
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Sitarz R et al . Gastroenterostoma
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Morais TC et al . Gastrointestinal
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Song MJ et al . Usefulness of PET/C
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A Sensitivity B Sensitivity C Sensi
Page 51 and 52: Song MJ et al . Usefulness of PET/C
Page 53 and 54: Song MJ et al . Usefulness of PET/C
Page 55 and 56: Bae GS et al . Anti-inflammatory ef
Page 59 and 60: B Myeloperoxidase activity (U/mg pr
Page 61 and 62: A Time (h) - 1 3 6 NJ4 B Relative H
Page 63 and 64: A C Time (h) - 1 3 6 NJ4-2 B Relati
Page 70 and 71: A Collagen staining (fold change) C
Page 72 and 73: CCl4/YGJ CCl4-13 wk CCl4-7 wk Contr
Page 74 and 75: CCl4/YGJ CCl4-13 wk CCl4-7 wk Contr
Page 76 and 77: liver and have potent proliferative
Page 78 and 79: A 8 wk 9 wk 10 wk 13 wk CCl4/YGJ CC
Page 80 and 81: Cheng JC. A Chinese Herbal Decoctio
Page 82 and 83: Singh R, Neo EN, Nordeen N, Shanmug
Page 84 and 85: etter patient tolerance with regard
Page 86: Key words: Intestinal alkaline phos
Page 89 and 90: Molnár K et al . iAP in pediatric
Page 97 and 98: Chung WC et al . Ulcer after gastre
Page 99: Yang HY et al . Early resection of
Page 104 and 105: Zhao WC, Zhang HB, Yang N, Fu Y, Qi
Page 106 and 107: level, or rapid enlargement of lesi
Page 108 and 109: Table 3 Area under the receiver ope
Page 111 and 112: Zhao WC et al . Prognostic factors
Page 113 and 114: Online Submissions: http://www.wjgn
Page 116 and 117: mV 0 2 4 6 8 cpm FD patients are sh
Page 118 and 119: COMMENTS Background Gastric motilit
Page 120 and 121: thirds partial hepatectomy (PH) in
Page 122: A Serum ALT (U/L) C Serum alkaline
Page 126 and 127: REFERENCES 1 Schibler U. Circadian
Page 132 and 133: positive patients were found to hav
Page 134: Online Submissions: http://www.wjgn
Page 140: 21 Tosolini M, Kirilovsky A, Mlecni
Page 147 and 148: Diao TJ et al . NO and hepatopulmon
Page 149 and 150: Gallegos M et al . Lymphogranuloma
Page 151 and 152: Gallegos M et al . Lymphogranuloma
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A Hadžić N et al . Diagnosis in B
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Hadžić N et al . Diagnosis in BAA
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A B Chung HJ et al . Choledocholith
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Chung HJ et al . Choledocholithiasi
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Instructions to authors ISSN and EI
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Instructions to authors AIM (no mor
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Instructions to authors Guidelines
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