1.The Prognosis and Recurrence Pattern of Right- and Left-Sided Colon Cancer in Stage II, Stage III, and Liver Metastasis After Curative Resection
Yasuyuki NAKAMURA ; Daisuke HOKUTO ; Fumikazu KOYAMA ; Yasuko MATSUO ; Takeo NOMI ; Takahiro YOSHIKAWA ; Naoki KAMITANI ; Tomomi SADAMITSU ; Takeshi TAKEI ; Yayoi MATSUMOTO ; Yosuke IWASA ; Kohei FUKUOKA ; Shinsaku OBARA ; Takayuki NAKAMOTO ; Hiroyuki KUGE ; Masayuki SHO
Annals of Coloproctology 2021;37(5):326-336
Purpose:
Primary tumor location of colon cancer has been reported to affect the prognosis after curative resection. However, some reports suggested the impact was varied by tumor stage. This study analyzed the prognostic impact of the sidedness of colon cancer in stages II, III, and liver metastasis after curative resection using propensity-matched analysis.
Methods:
Right-sided colon cancer was defined as a tumor located from cecum to splenic flexure, while any more distal colon cancer was defined as left-sided colon cancer. Patients who underwent curative resection at Nara Medical University hospital between 2000 and 2016 were analyzed.
Results:
There were 110 patients with stage II, 100 patients with stage III, and 106 patients with liver metastasis. After propensity matching, 28 pairs with stage II and 32 pairs with stage III were identified. In the patients with stage II, overall survival (OS) and recurrence-free survival (RFS) were not significantly different for right- and left-sided colon cancers. In the patients with stage III, OS and RFS were significantly worse in right-sided colon cancer. In those with liver metastasis, OS of right-sided colon cancer was significantly worse than left-sided disease, while RFS was similar. Regarding metachronous liver metastasis, the difference was observed only in the patients whose primary colon cancer was stage III. In each stage, significantly higher rate of peritoneal recurrence was found in those with right-sided colon cancer.
Conclusion
Sidedness of colon cancer had a significant and varied prognostic impact in patients with stage II, III, and liver metastasis after curative resection.
2.Assessment of the efficacy and safety of a Judo exercise program in improving the quality of life among elderly patients
Naoki SAKUYAMA ; Takeshi KAMITANI ; Akira IKUMI ; Masakazu KIDA ; Youhei KANESHIRO ; Keiichi AKIYAMA
Journal of Rural Medicine 2021;16(4):229-235
Objectives: Several reports have shown that Tai Chi Chuan can be an effective way to prevent falls among the elderly. However, an exercise program that can prevent injury during falls has not been reported previously. The judo technique called ukemi is used to prevent injuries. To evaluate whether a judo-based exercise program could prevent falls in the elderly, we had the participants practice ukemi as part of a therapeutic routine. The purpose of this study was to examine the clinical significance of the program and to predict its safety.Methods: From July 2016 to March 2017, we examined 53 individuals who participated in the exercise program. The individuals were divided into high (n=39) and low (n=14) movement ability groups (HMA and LMA groups, respectively), and their physical and psychological functions were evaluated using scores from the Short-Form Health Survey 36. We also collected and analyzed data from questionnaires obtained from 384 patients who participated in the program from July 2016 to July 2019.Results: The HMA group showed a significant increase in the mental component summary scores before and after the exercise program. In the LMA group, physical functioning, social functioning, and physical component summary scores were significantly improved. Of the participants surveyed, 94.8% had a high level of satisfaction, and 93.2% began accepting the exercise as a daily habit. No adverse events were observed during these exercises.Conclusion: This novel exercise program was performed safely, and positive effects were observed, especially in individuals with a low quality of life.