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The prognosis of colorectal cancer depends on a multitude of factors that can be grouped into several categories: tumor-related factors, clinical factors, histopathological factors, and biological factors (oncogenetic and molecular). Colorectal cancer is the second leading cause of death in the world and affects both sexes equally. Approximately 40% of patients relapse after surgery with curative intent for rectal cancer in the form of distant metastases or local recurrences. Clinical factors are represented by: age, sex, complications, location of the primary tumor, symptoms and perioperative blood transfusions. Factors related to the primary tumor are classified according to tumor stage, tumor size, invasion of peritoneal serosa and adjacent organs, appearance of primary tumor, degree of obstruction of the rectal lumen, and resection margins that may influence residual tumor occurrence. Biochemical and genetic factors may mark the presence of tumor recurrence by increasing the CEA (embryonic carcinoma) marker. RAS mutations (KRAS and NRAS) are the most common oncogenetic mutations in cancer, and KRAS mutations are associated with more aggressive tumors, increased metastatic potential, and a poor prognosis. Predictive histopathological factors are: invasion of regional lymph nodes, degree of tumor differentiation, perineural, vascular and lymphatic invasion, budding phenomenon, peritumoral immune reaction and the evidence of tumor cells. [ABSTRACT FROM AUTHOR]

The quality of surgery, the limits of resection, the total excretion of "mesorectum", mechanical or manual anastomosis and pre-and postoperative oncologic treatment of rectal cancer, all these, may influence the incidence of local recurrence. We have analyzed the case of a 62-year old patient with rectal bleeding, diarrhea, and rectal tenesmus. The colonoscopy revealed a rectal tumor located at 10 cm from anal-rectal limit. A biopsy was taken from the tumor: moderately differentiated adenocarcinoma. CEA and CA19.9 tumor markers were found within normal limits. There was performed rectal resection with end-to-end colonic - rectal anastomosis with Stapler 32. Postoperatively, pathological examination: rectal adenocarcinoma NOS with low degree of malignancy G2 - moderately differentiated, diffuse infiltration to the musculature, without metastasis in regional nodes (only identified 5), completely excised surgically - it was classified as pT2pNo (G2) stage. Postoperatively, the patient did not perform oncology treatment. Colonoscopy which was performed 1 year after surgery, revealed a bleeding tumor located at the anastomosis level. Biopsies were taken from the anastomosis tumor. The result confirms the local recurrence of invasive adenocarcinoma. Milles rectum amputation is decided and practiced. Postoperatively the patient performs oncological treatment. Preoperative staging is an important factor in determining the indication of radiotherapy. [ABSTRACT FROM AUTHOR]

Colorectal cancer is a frequently encountered disease. In most countries, it represents the second leading cause of cancer death. The treatment with radical intent of this condition is surgical. Objective: Through this study, we want to update some data regarding the impact of nutrition and the preoperative mechanical bowel preparation on postoperative complications, in patients who need surgical treatment for colorectal cancer. Material and Method: Relevant articles in the field, contained in international databases were analysed, with no language exclusion, including clinical trials and meta-analyses performed between 1994 and 2015. Conclusions: Preoperative preparation is particularly important in the postoperative evolution of the patients with colorectal cancer and it is based on several main principles: nutritional support, antimicrobial treatment and mechanical bowel preparation. [ABSTRACT FROM AUTHOR]

Acute pancreatitis is an acute inflammatory process of the pancreatic acinar cells. In severe cases of acute pancreatitis development can lead to multiple organ dysfunction. International studies in recent decades have highlighted numerous prognostic factors in severe acute pancreatitis: clinical, biological, intraopera-tive and pathological. Our research aims to identify the factors of prognosis in severe acute pancreatitis. The study was prospective and included a sample of 238 patients diagnosed with acute pancreatitis and its complications. Of all patients, 43.28% had severe acute pancreatitis, and 58.83% were male. Age over 55 years was found in 52.43% of patients with severe form and only 33.33% of patients with mild form. Female patients with obesity and aged between 60 and 80 years more frequently develop acute pancreatitis. Mortality among obese patients with the severe form is four times higher than in obese patients with mild form. Although female patients appear more frequently develop complications, total number of deaths occurring in obese patients is higher in males compared to the females. Conclusion. Age and obesity are factors useful for more precise prediction of severity of acute pancreatitis. [ABSTRACT FROM AUTHOR]