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Publications (10 of 37) Show all publications
Rutegård, M., Svensson, J., Segelman, J., Matthiessen, P., Lydrup, M.-L. & Park, J. M. (2024). Anastomotic leakage in relation to type of mesorectal excision and defunctioning stoma use in anterior resection for rectal cancer. Diseases of the Colon & Rectum, 67(3), 398-405
Open this publication in new window or tab >>Anastomotic leakage in relation to type of mesorectal excision and defunctioning stoma use in anterior resection for rectal cancer
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2024 (English)In: Diseases of the Colon & Rectum, ISSN 0012-3706, E-ISSN 1530-0358, Vol. 67, no 3, p. 398-405Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Anastomotic leakage after anterior resection for rectal cancer is more common after total mesorectal excision compared to partial mesorectal excision but might be mitigated by a defunctioning stoma.

OBJECTIVE: The aim is to assess how anastomotic leakage is affected by type of mesorectal excision and defunctioning stoma use.

DESIGN: This is a retrospective multicenter cohort study evaluating anastomotic leakage after anterior resection. Multivariable Cox regression with HRs and 95% CIs was used to contrast mesorectal excision types and defunctioning stoma use with respect to anastomotic leakage, with adjustment for confounding.

SETTINGS: This multicenter study included patients from 11 Swedish hospitals between 2014 and 2018.

PATIENTS: Patients who underwent anterior resection for rectal cancer were included.

MAIN OUTCOMES MEASURES: Anastomotic leakage rates within and after 30 days of surgery are described up to 1 year after surgery.

RESULTS: Anastomotic leakage occurred in 24.2% and 9.0% of 1126 patients operated with total and partial mesorectal excision, respectively. Partial compared to total mesorectal excision was associated with a reduction in leakage, with an adjusted HR of 0.46 (95% CI, 0.29-0.74). Early leak rates within 30 days were 14.9% with and 12.5% without a stoma, whereas late leak rates after 30 days were 7.5% with and 1.9% without a stoma. After adjustment, defunctioning stoma was associated with a lower early leak rate (HR 0.47; 95% CI, 0.28-0.77). However, the late leak rate was nonsignificantly higher in patients with defunctioning stomas (HR 1.69; 95% CI, 0.59-4.85).

LIMITATIONS: This study was limited by its retrospective observational study design.

CONCLUSIONS: Anastomotic leakage is common up to 1 year after anterior resection for rectal cancer, where partial mesorectal excision is associated with a lower leak rate. Defunctioning stomas seem to decrease the occurrence of leakage, although partially by only delaying the diagnosis. See Video Abstract.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2024
Keywords
Anterior resection, Leak, Mesorectal excision, Rectal, Stoma
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-222965 (URN)10.1097/DCR.0000000000003050 (DOI)001169589200009 ()37994449 (PubMedID)2-s2.0-85184657029 (Scopus ID)
Funder
Knut and Alice Wallenberg Foundation, RV-762241Swedish Society of Medicine, SLS-934594Cancerforskningsfonden i Norrland, AMP 19-978Bengt Ihres Foundation, SLS-934603Swedish Cancer Society, CAN 2018/589
Available from: 2024-04-11 Created: 2024-04-11 Last updated: 2024-04-11Bibliographically approved
Jansson, M., Lindberg, J., Rask, G., Svensson, J., Billing, O., Nazemroaya, A., . . . Sund, M. (2024). Stromal type I collagen in breast cancer: correlation to prognostic biomarkers and prediction of chemotherapy response. Clinical Breast Cancer
Open this publication in new window or tab >>Stromal type I collagen in breast cancer: correlation to prognostic biomarkers and prediction of chemotherapy response
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2024 (English)In: Clinical Breast Cancer, ISSN 1526-8209, E-ISSN 1938-0666Article in journal (Refereed) In press
Abstract [en]

Introduction: Fibrillar collagens accumulate in the breast cancer stroma and appear as poorly defined spiculated masses in mammography imaging. The prognostic value of tissue type I collagen remains elusive in treatment-naïve and chemotherapy-treated breast cancer patients. Here, type I collagen mRNA and protein expression were analysed in 2 large independent breast cancer cohorts. Levels were related to clinicopathological parameters, prognostic biomarkers, and outcome.

Method: COL1A1 mRNA expression was analysed in 2509 patients with breast cancer obtained from the cBioPortal database. Type I collagen protein expression was studied by immunohistochemistry in 1395 women diagnosed with early invasive breast cancer.

Results: Low COL1A1 mRNA and protein levels correlated with poor prognosis features, such as hormone receptor negativity, high histological grade, triple-negative subtype, node positivity, and tumour size. In unadjusted analysis, high stromal type I collagen protein expression was associated with improved overall survival (OS) (HR = 0.78, 95% CI = 0.61-0.99, p = .043) and trended towards improved breast cancer–specific survival (BCSS) (HR = 0.65, 95% CI = 0.42-1.01, P = 0.053), although these findings were lost after adjustment for other clinical variables. In unadjusted analysis, high expression of type I collagen was associated with better OS (HR = 0.70, 95% CI = 0.55-0.90, P = .006) and BCSS (HR = 0.55, 95% CI = 0.34-0.88, P = .014) among patients not receiving chemotherapy. Strikingly, the opposite was observed among patients receiving chemotherapy. There, high expression of type I collagen was instead associated with worse OS (HR = 1.83, 95% CI = 0.65-5.14, P = .25) and BCSS (HR = 1.72, 95% CI = 0.54-5.50, P = .357).

Conclusion: Low stromal type I collagen mRNA and protein expression are associated with unfavourable tumour characteristics in breast cancer. Stromal type I collagen might predict chemotherapy response.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Breast cancer, Chemotherapy response, Extracellular matrix, Tumour microenvironment, Type I collagen
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-223260 (URN)10.1016/j.clbc.2024.02.015 (DOI)38485557 (PubMedID)2-s2.0-85187983725 (Scopus ID)
Funder
The Breast Cancer FoundationRegion Västerbotten, RV-866131Region Västerbotten, RV-932421Region Västerbotten, RV-764621Visare Norr, VISARENORR931408Visare Norr, VISARENORR750491Percy Falks stiftelse för forskning beträffande prostatacancer och bröstcancer
Available from: 2024-04-18 Created: 2024-04-18 Last updated: 2024-04-18
Wiberg, E., Vega, A., Eriksson, V., Banday, V. S., Svensson, J., Eriksson, E. K., . . . Sherif, A. (2023). A validation study of cT-categories in the Swedish national urinary bladder cancer register - Norrland University Hospital. Journal of Personalized Medicine, 13(7), Article ID 1163.
Open this publication in new window or tab >>A validation study of cT-categories in the Swedish national urinary bladder cancer register - Norrland University Hospital
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2023 (English)In: Journal of Personalized Medicine, E-ISSN 2075-4426, Vol. 13, no 7, article id 1163Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In Sweden, all patients with urinary bladder cancer (UBC) are recorded in the Swedish National Register for Urinary Bladder Cancer (SNRUBC). The purpose of this study was to validate the registered clinical tumour categories (cT-categories) in the SNRUBC for Norrland University Hospital, Sweden, from 2009 to 2020, inclusive.

METHODS: The medical records of all 295 patients who underwent radical cystectomy for the treatment of UBC were reviewed retrospectively. Possible factors impacting the cT-categories were identified. To optimise cT-classification, computed tomography urography of all patients with suspected tumour-associated hydronephrosis (TAH) or suspected tumour in bladder diverticulum (TIBD) were retrospectively reviewed by a radiologist. Discrepancy was tested with a logistic regression model.

RESULTS: cT-categories differed in 87 cases (29.5%). Adjusted logistic regression analysis found TIBD and TAH as significant predictors for incorrect registration; OR = 7.71 (p < 0.001), and OR = 17.7, (p < 0.001), respectively. In total, 48 patients (68.6%) with TAH and 12 patients (52.2%) with TIBD showed discrepancy regarding the cT-category. Incorrect registration was mostly observed during the years 2009-2012.

CONCLUSION: The study revealed substantial incorrect registration of cT-categories in SNRUBC. A major part of the misclassifications was related to TAH and TIBD. Registration of these variables in the SNRUBC might be considered to improve correct cT-classification.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
hydronephrosis, neoplasm staging, tumour in bladder diverticulum, urinary bladder neoplasm, validation study
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-212875 (URN)10.3390/jpm13071163 (DOI)001038517500001 ()37511776 (PubMedID)2-s2.0-85166304439 (Scopus ID)
Available from: 2023-08-14 Created: 2023-08-14 Last updated: 2023-09-26Bibliographically approved
Sandén, G., Svensson, J., Ljuslinder, I. & Rutegård, M. (2023). Defunctioning stoma before neoadjuvant treatment or resection of endoscopically obstructing rectal cancer. International Journal of Colorectal Disease, 38(1), Article ID 24.
Open this publication in new window or tab >>Defunctioning stoma before neoadjuvant treatment or resection of endoscopically obstructing rectal cancer
2023 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 38, no 1, article id 24Article in journal (Refereed) Published
Abstract [en]

Aim: To investigate whether patients with endoscopically untraversable rectal cancer may benefit from a defunctioning stoma created before neoadjuvant therapy or resectional surgery.

Methods: This retrospective study comprise patients diagnosed with rectal cancer during 2007–2020 in Region Västerbotten, Sweden. The primary outcome was time between diagnosis and any treatment, while survival and the incidence of complications were secondary outcomes. Excluded were patients without endoscopic obstruction, patients already having a stoma, patients with recurrent disease, palliative patients, and patients receiving a stoma shortly after diagnosis due to any urgent bowel-related complication. Data were obtained from the Swedish Colorectal Cancer Registry and medical records. Kaplan–Meier failure curves were drawn, and a multivariable Cox regression model was employed for confounding adjustment.

Results: Out of 843 patients, 57 remained after applying exclusion criteria. Some 12/57 (21%) patients received a planned stoma before treatment, and the remainder received upfront neoadjuvant therapy or surgery. Median time to any treatment was 51 days for the planned stoma group and 36 days for the control group, with an adjusted hazard ratio of 0.28 (95% confidence interval: 0.12–0.64). Complications occurred at a rate of 5/12 (42%) and 7/45 (16%) in the planned stoma group and control group, respectively. Survival was similar between groups.

Conclusion: A planned stoma results in treatment delay, but it remains unclear whether this is clinically relevant. Complications were more common in the planned stoma group, although the data are limited. While larger studies are needed, it seems feasible to avoid defunctioning stomas even in endoscopically obstructing rectal cancers.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Bowel Obstruction, Endoscopy, Rectal Cancer, Stoma
National Category
Gastroenterology and Hepatology Surgery
Identifiers
urn:nbn:se:umu:diva-204495 (URN)10.1007/s00384-023-04318-8 (DOI)000918433400001 ()36698033 (PubMedID)2-s2.0-85146873003 (Scopus ID)
Funder
Knut and Alice Wallenberg FoundationSwedish Society of Medicine
Available from: 2023-02-08 Created: 2023-02-08 Last updated: 2024-02-01Bibliographically approved
Thermaenius, F., Björnstig, U., Svensson, J. & Westman, A. (2023). Fatalities in Swedish fire-related car crashes from a toxicologic perspective. Traffic Injury Prevention, 24(1), 21-25
Open this publication in new window or tab >>Fatalities in Swedish fire-related car crashes from a toxicologic perspective
2023 (English)In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 24, no 1, p. 21-25Article in journal (Refereed) Published
Abstract [en]

Objective: Vehicle materials developments raise concerns about new patterns of vehicle fire toxic gas emissions. This study aimed to describe toxicologic components in a recent material of fatal car crashes on Swedish roads in which the vehicle caught fire and compare the results to a previous material.

Methods: Retrospective registry study. All fatal car crashes with fire in Sweden 2009–2018 were extracted from the Swedish Transport Administration’s In-Depth Studies Database and compared with an earlier study of the time period 1998–2008.

Results: A total of 79 crashes and 94 fatalities were included. Carbon monoxide (COHb) blood levels >10% were found in 13 cases. Hydrogen cyanide (HCN) blood levels 0.1–1.7 µg/g were found in 10 cases. In 31 of the cases the person had a blood alcohol level (BAC) >0.2‰, which is the legal driving limit in Sweden. A total of 15 people died due to burn injuries and 2 individuals died due to toxic gas emissions without any other fatal traumatic injury. Total number of deaths in fire-related crashes halved from 181 (1998–2008) to 94 (2009–2018) but the percentage of fatalities in burning vehicles was unaltered (5% vs. 6%). The proportion of fatalities with HCN in the blood increased from 2% between 1998–2008 to 10% during 2009–2018 (p = 0.006). The age of the car involved in a crash increased by 0.26 years per calendar year (p = 0.001).

Conclusions: The proportion of fatalities with measured levels of HCN in the blood has increased. Eleven of the 15 burn injury fatalities had high levels of alcohol, HCN, or COHb, possibly contributing to an inability to leave a burning vehicle. Faster rescue brought by improved specific education and training of ambulance and rescue services personnel may be of future importance, as may on-scene antidote administration and revised regulations of vehicle flammability.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023
Keywords
car crashes, carbon monoxide, hydrogen cyanide, Toxic gas emissions, vehicle fire
National Category
Vehicle Engineering Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-202004 (URN)10.1080/15389588.2022.2148831 (DOI)000894957000001 ()36480228 (PubMedID)2-s2.0-85144170224 (Scopus ID)
Funder
Swedish Civil Contingencies Agency, 2019-11351
Available from: 2022-12-29 Created: 2022-12-29 Last updated: 2023-09-26Bibliographically approved
Arnelo, U., Valente, R., Scandavini, C. M., Halimi, A., Mucelli, R. M. o., Rangelova, E., . . . Del Chiaro, M. (2023). Intraoperative pancreatoscopy can improve the detection of skip lesions during surgery for intraductal papillary mucinous neoplasia: a pilot study. Pancreatology (Print), 23(6), 704-711
Open this publication in new window or tab >>Intraoperative pancreatoscopy can improve the detection of skip lesions during surgery for intraductal papillary mucinous neoplasia: a pilot study
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2023 (English)In: Pancreatology (Print), ISSN 1424-3903, E-ISSN 1424-3911, Vol. 23, no 6, p. 704-711Article in journal (Refereed) Published
Abstract [en]

Objectives: Intraoperative pancreatoscopy is a promising procedure that might guide surgical resection for suspected main duct (MD) and mixed type (MT) intraductal papillary mucinous neoplasms (IPMNs). The aim of the present study was to assess the diagnostic yield and clinical impact of intraoperative pancreatoscopy in patients operated on for MD and MT-IPMNs.

Methods: This is a retrospective cohort study. Patients undergoing surgery for suspected MD or MT-IPMN underwent intraoperative pancreatoscopy and frozen section analysis. In all patients who required extended resection due to pancreatoscopic findings, we compared the final histology with the results of the intraoperative frozen section analysis.

Results: In total, 46 patients, 48% females, mean age (range) 67 years (45–82 years) underwent intraoperative pancreatoscopy. No mortality or procedure related complications were observed. Pancreatoscopy changed the operative course in 30 patients (65%), leading to extended resections in 20 patients (43%) and to parenchyma sparing procedures in 10 patients (22%). Analyzing the group of patients who underwent extended resections, 7 (35%) displayed lesions that needed further surgical treatment (six high grade dysplasia and one with G1 pancreatic neuroendocrine tumor) and among those 7, just 1 (14%) would have been detected exclusively with histological frozen section analysis of the transection margin. The combination of both pancreatoscopy and frozen section analysis lead to 86% sensitivity and 92% specificity for the detection of pathological tissue in the remnant pancreas.

Conclusion: Intraoperative pancreatoscopy is a safe and feasible procedure and might allow the detection of skip lesions during surgery for suspect MD-involving IPMNs.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Accuracy, Complication, Intra-operative pancreatoscopy, Intraductal papillary mucinous neoplasia, Pancreatic surgery
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-211808 (URN)10.1016/j.pan.2023.06.006 (DOI)001075021500001 ()37336668 (PubMedID)2-s2.0-85162859765 (Scopus ID)
Funder
Swedish Cancer Society, 19 0513 Fk 01 HBengt Ihres FoundationCancer and Allergy Foundation, 10384Cancerforskningsfonden i Norrland, AMP 21-1058Cancerforskningsfonden i Norrland, LP22-2301IngaBritt and Arne Lundberg’s Research FoundationSwedish Society of Medicine, SLS-961923Swedish Society of Medicine, SLS-961919
Available from: 2023-07-11 Created: 2023-07-11 Last updated: 2023-12-29Bibliographically approved
Deutschmann, M., Borgström, E., Yassin Falk, D., Steinvall, A. & Svensson, J. (2023). “It ain’t what you say. It’s the way you say it”: adapting the matched guise technique (MGT) to raise awareness of accentedness stereotyping effects among Swedish pre-service teachers. Language Awareness, 32(2), 255-277
Open this publication in new window or tab >>“It ain’t what you say. It’s the way you say it”: adapting the matched guise technique (MGT) to raise awareness of accentedness stereotyping effects among Swedish pre-service teachers
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2023 (English)In: Language Awareness, ISSN 0965-8416, E-ISSN 1747-7565, Vol. 32, no 2, p. 255-277Article in journal (Refereed) Published
Abstract [en]

The study describes a pedagogic adaptation of the matched guise technique with the aim to raise linguistic self-awareness of L2 accentedness stereotyping effects among Swedish pre-service teachers. In the experiment, 290 students attending teacher training programs were exposed to one of two matched guises, representing either L1 accented Swedish, or L2 accented Swedish. Both guises were based on the same recording, but the L2 accented version had been digitally manipulated using cut-and-paste techniques in order to replicate certain vowel sounds (the [u:]-sound in particular) associated with low-prestige Swedish L2 accentedness. The findings from this experiment were then used as starting point for language awareness raising activities. Our overall results show that the L2 accented manipulated recording was evaluated more favourably than the original L1 accented recording on all investigated variables. One proposed explanation is that respondents were inadvertently influenced by so-called shifting standards effects, i.e. lower standards/expectations are being used as reference points when evaluating the L2 accented recording. This tendency, however, seemed to be less apparent among respondents with bi/multilingual linguistic identities. Following debriefing discussions based on the experiment findings, there were clear indications that respondents did become more aware of inadvertent linguistic stereotyping by participating in the activities.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023
Keywords
L2 accentedness, Language awareness raising, linguistic stereotyping, matched guise technique, pedagogic design, reverse linguistic stereotyping
National Category
General Language Studies and Linguistics
Identifiers
urn:nbn:se:umu:diva-197795 (URN)10.1080/09658416.2022.2067556 (DOI)000793085300001 ()2-s2.0-85132661870 (Scopus ID)
Available from: 2022-07-05 Created: 2022-07-05 Last updated: 2023-09-26Bibliographically approved
Molnár, A., Halimi, A., Svensson, J., Bayadsi, H., Innala, M., Hansén, M., . . . Franklin, O. (2023). Portomesenteric venous contact ≤180° and overall survival in resectable head and body pancreatic adenocarcinoma treated with upfront surgery. European Journal of Surgical Oncology, 49(11), Article ID 107097.
Open this publication in new window or tab >>Portomesenteric venous contact ≤180° and overall survival in resectable head and body pancreatic adenocarcinoma treated with upfront surgery
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2023 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 49, no 11, article id 107097Article in journal (Refereed) Published
Abstract [en]

Introduction: Upfront surgery is the standard of care for resectable pancreatic cancer, defined as the absence of or ≤180° tumour contact with the portal/superior mesenteric vein. We hypothesized that portomesenteric venous contact is prognostically unfavourable and aimed to assess whether it is associated with poorer outcomes compared with no venous contact in resectable head and body pancreatic cancer.

Methods: This single-centre retrospective study included patients undergoing upfront surgery for resectable head and body pancreatic cancer in 2010–2020 at Umeå University Hospital, Sweden. No venous contact was compared with portomesenteric venous contact of ≤180° based on preoperative imaging. Survival on an intention-to-treat basis was compared with Kaplan-Meier curves, a log-rank test and Cox proportional hazards models.

Results: The final study cohort included 39 patients with portomesenteric venous contact and 144 patients without venous contact. Patients with portomesenteric tumour contact had a median overall survival of 15.3 months compared to 23.0 months (log rank P = 0.059). Portomesenteric venous contact was an independent negative prognostic factor for survival in the multivariable Cox model (HR 1.68; 95% CI 1.11–2.55, P = 0.014) and was associated with higher rates of microscopically non-radical resections (R1) (50% vs 26.1%, P = 0.012) and pathological lymph node metastasis (76.7% vs 56.8%, P = 0.012). There was no difference in adjuvant chemotherapy receipt or postoperative complications between the groups.

Conclusions: Portomesenteric venous contact is associated with poorer overall survival and higher rates of R1 resections and lymph node metastasis in patients with resectable head and body pancreatic cancer treated with upfront surgery.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Pancreatic adenocarcinoma
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-214812 (URN)10.1016/j.ejso.2023.107097 (DOI)37804583 (PubMedID)2-s2.0-85173010733 (Scopus ID)
Funder
Umeå University, AMP 23-1127Region Västerbotten, RV-979958Swedish Society of Medicine, SLS-960379The Royal Swedish Academy of Sciences, LM2021-0010Region Västerbotten, RV-982574Region Västerbotten, RV--982481Bengt Ihres Foundation, SLS-960529Knut and Alice Wallenberg Foundation, RV-769711
Available from: 2023-10-02 Created: 2023-10-02 Last updated: 2024-02-01Bibliographically approved
Rutegård, M., Svensson, J., Segelman, J., Matthiessen, P., Lydrup, M.-L. & Park, J. (2023). Splenic flexure mobilization and anastomotic leakage in anterior resection for rectal cancer: a multicentre cohort study. Scandinavian Journal of Surgery, 112(4), 246-255
Open this publication in new window or tab >>Splenic flexure mobilization and anastomotic leakage in anterior resection for rectal cancer: a multicentre cohort study
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2023 (English)In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 112, no 4, p. 246-255Article in journal (Refereed) Published
Abstract [en]

Background and objective: Some colorectal surgeons advocate routine splenic flexure mobilization (SFM) when performing anterior resection for rectal cancer to ensure a tension-free anastomosis. Meta-analyses of smaller studies suggest that this approach does not influence anastomotic leakage rates, but larger multicentre studies are needed to confirm the safety of a selective strategy. The aim of this study is to evaluate the impact of SFM on anastomotic leakage.

Methods: This is a retrospective multicentre cohort study, comprising 1109 patients operated with anterior resection for rectal cancer in 2014–2018. Exposure was SFM, while anastomotic leakage within a year constituted the outcome. Stratified analyses were performed for type of mesorectal excision and surgical approach, as well as sensitivity analysis considering vascular tie placement. Multivariable Cox regression with hazard ratios (HRs) and 95% confidence intervals (CIs) was employed to adjust for confounding, while multiple imputation was used for missing data.

Results: SFM was performed in 381 patients (34.4%). Anastomotic leakage occurred in 83 (21.8%) and 123 (20.3%) patients operated with and without SFM, respectively. SFM was neither clearly detrimental nor beneficial regarding anastomotic leakage (adjusted HR = 0.82; 95% CI: 0.59–1.15), with no apparent differences for total or partial mesorectal excision and minimally invasive or open surgery. Concurrent high vascular ligation did not impact these results, and there was no evidence of interaction from centers with a more common use of SFM.

Conclusions: SFM did not seem to influence the risk of anastomotic leakage after anterior resection for rectal cancer, regardless of type of mesorectal excision, use of minimally invasive surgery, or high vascular ligation.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
adenocarcinoma, dehiscence, Insufficiency, leak, rectum, splenic flexure
National Category
Surgery Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-214537 (URN)10.1177/14574969231181222 (DOI)001060070200001 ()37675547 (PubMedID)2-s2.0-85170522374 (Scopus ID)
Funder
Knut and Alice Wallenberg Foundation, RV-762241Swedish Society of Medicine, SLS-934594Cancerforskningsfonden i Norrland, AMP 19-978Bengt Ihres Foundation, SLS-934603Swedish Cancer Society, CAN 2018/589
Available from: 2023-09-26 Created: 2023-09-26 Last updated: 2024-02-01Bibliographically approved
Schulz Hägersten, E., Ottosson, K., Pelander, S., Johansson, M., Huge, Y., Aljabery, F., . . . Sherif, A. (2023). The risk of thromboembolism in patients with muscle invasive bladder cancer before and after cystectomy depending on blood group and neoadjuvant chemotherapy: a multicentre retrospective cohort study. Journal of Personalized Medicine, 13(9), Article ID 1355.
Open this publication in new window or tab >>The risk of thromboembolism in patients with muscle invasive bladder cancer before and after cystectomy depending on blood group and neoadjuvant chemotherapy: a multicentre retrospective cohort study
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2023 (English)In: Journal of Personalized Medicine, E-ISSN 2075-4426, Vol. 13, no 9, article id 1355Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Previous studies have indicated that patients with muscle-invasive bladder cancer with non-O blood types have an increased risk of experiencing thromboembolic events (TEEs). This is finding is in relation to neoadjuvant-chemotherapy (NAC)-naïve patients.

AIM: to establish the risk of TEEs and any association with blood types among NAC patients as well as NAC-naïve patients.

METHODS: Cystectomized patients at four centres treated from 2009 to 2018 (n = 244) were analysed. The quantities of patients corresponding to each blood group were as follows: A-108 (44%); O-99 (41%); B-30 (12%); and AB-7 (3%). NAC patients (n = 167) and NAC-naïve NAC-eligible patients (n = 77) were assessed. In total, 54 women (22%) and 190 men (78%), with a median age of 69 years, were included in the study. The occurrence of any type of TEE from six months pre-cystectomy to 12-24 months after was analysed using logistic regression adjusted for NAC and confounders.

RESULTS: Sixty-six TEEs were detected in 21% of the patients (n = 52). Pulmonary embolus (n = 33) and deep venous thrombosis (n = 11) were the most common forms. No significant differences between blood types were found in the analysis, although B blood type had a nearly significant increased crude risk compared with O blood type, for which there was an OR of 2.48 (95% CI 0.98-6.36). Adjustment for NAC and covariates weakened the OR, which plummeted to 1.98 (95% CI 0.71-5.51).

CONCLUSIONS: No significant associations were found between blood types and TEE occurrences in this cohort including both NAC and NAC-naïve NAC-eligible patients.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
ABO blood group system, complications, cystectomy, neoadjuvant therapy, thromboembolism, urinary bladder neoplasms
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-214814 (URN)10.3390/jpm13091355 (DOI)001073713500001 ()37763123 (PubMedID)2-s2.0-85172903119 (Scopus ID)
Funder
Region Västerbotten, RV-848051
Available from: 2023-10-02 Created: 2023-10-02 Last updated: 2024-02-01Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8601-0159

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