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Hallböök, Olof
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Publications (10 of 49) Show all publications
Erlandsson, J., Holm, T., Pettersson, D., Berglund, Å., Cedermark, B., Radu, C., . . . Martling, A. (2017). Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial. The Lancet Oncology, 18(3), 336-346
Open this publication in new window or tab >>Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial
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2017 (English)In: The Lancet Oncology, ISSN 1470-2045, E-ISSN 1474-5488, Vol. 18, no 3, p. 336-346Article in journal (Refereed) Published
Abstract [en]

Background Radiotherapy reduces the risk of local recurrence in rectal cancer. However, the optimal radiotherapy fractionation and interval between radiotherapy and surgery is still under debate. We aimed to study recurrence in patients randomised between three different radiotherapy regimens with respect to fractionation and time to surgery. Methods In this multicentre, randomised, non-blinded, phase 3, non-inferiority trial (Stockholm III), all patients with a biopsy-proven adenocarcinoma of the rectum, without signs of non-resectability or distant metastases, without severe cardiovascular comorbidity, and planned for an abdominal resection from 18 Swedish hospitals were eligible. Participants were randomly assigned with permuted blocks, stratified by participating centre, to receive either 5 x 5 Gy radiation dose with surgery within 1 week (short-course radiotherapy) or after 4-8 weeks (short-course radiotherapy with delay) or 25 x 2 Gy radiation dose with surgery after 4-8 weeks (long-course radiotherapy with delay). After a protocol amendment, randomisation could include all three treatments or just the two short-course radiotherapy treatments, per hospital preference. The primary endpoint was time to local recurrence calculated from the date of randomisation to the date of local recurrence. Comparisons between treatment groups were deemed non-inferior if the upper limit of a double-sided 90% CI for the hazard ratio (HR) did not exceed 1.7. Patients were analysed according to intention to treat for all endpoints. This study is registered with ClinicalTrials.gov, number NCT00904813. Findings Between Oct 5, 1998, and Jan 31, 2013, 840 patients were recruited and randomised; 385 patients in the three-arm randomisation, of whom 129 patients were randomly assigned to short-course radiotherapy, 128 to short-course radiotherapy with delay, and 128 to long-course radiotherapy with delay, and 455 patients in the two-arm randomisation, of whom 228 were randomly assigned to short-course radiotherapy and 227 to short-course radiotherapy with delay. In patients with any local recurrence, median time from date of randomisation to local recurrence in the pooled short-course radiotherapy comparison was 33.4 months (range 18.2-62.2) in the short-course radiotherapy group and 19.3 months (8.5-39.5) in the short-course radiotherapy with delay group. Median time to local recurrence in the long-course radiotherapy with delay group was 33.3 months (range 17.8-114.3). Cumulative incidence of local recurrence in the whole trial was eight of 357 patients who received short-course radiotherapy, ten of 355 who received short-course radiotherapy with delay, and seven of 128 who received long-course radiotherapy (HR vs short-course radiotherapy: short-course radiotherapy with delay 1.44 [95% CI 0.41-5.11]; long-course radiotherapy with delay 2.24 [0.71-7.10]; p=0.48; both deemed non-inferior). Acute radiation-induced toxicity was recorded in one patient (amp;lt;1%) of 357 after short-course radiotherapy, 23 (7%) of 355 after short-course radiotherapy with delay, and six (5%) of 128 patients after long-course radiotherapy with delay. Frequency of postoperative complications was similar between all arms when the three-arm randomisation was analysed (65 [50%] of 129 patients in the short-course radiotherapy group; 48 [38%] of 128 patients in the short-course radiotherapy with delay group; 50 [39%] of 128 patients in the long-course radiotherapy with delay group; odds ratio [OR] vs short-course radiotherapy: short-course radiotherapy with delay 0.59 [95% CI 0.36-0.97], long-course radiotherapy with delay 0.63 [0.38-1.04], p=0.075). However, in a pooled analysis of the two short-course radiotherapy regimens, the risk of postoperative complications was significantly lower after short-course radiotherapy with delay than after short-course radiotherapy (144 [53%] of 355 vs 188 [41%] of 357; OR 0.61 [95% CI 0.45-0.83] p=0.001). Interpretation Delaying surgery after short-course radiotherapy gives similar oncological results compared with short-course radiotherapy with immediate surgery. Long-course radiotherapy with delay is similar to both short-course radiotherapy regimens, but prolongs the treatment time substantially. Although radiation-induced toxicity was seen after short-course radiotherapy with delay, postoperative complications were significantly reduced compared with short-course radiotherapy. Based on these findings, we suggest that short-course radiotherapy with delay to surgery is a useful alternative to conventional short-course radiotherapy with immediate surgery.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC, 2017
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-136049 (URN)10.1016/S1470-2045(17)30086-4 (DOI)000396344600045 ()
Note

Funding Agencies|Swedish Research Council; Swedish Cancer Society; Stockholm Cancer Society; Stockholm County Council; Karolinska Institutet

Available from: 2017-03-27 Created: 2017-03-27 Last updated: 2018-05-02
Loftås, P., Arbman, G., Fomichov Casaballe, V. & Hallböök, O. (2016). Nodal involvement in luminal complete response after neoadjuvant treatment for rectal cancer. European Journal of Surgical Oncology, 42(6), 801-807
Open this publication in new window or tab >>Nodal involvement in luminal complete response after neoadjuvant treatment for rectal cancer
2016 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 42, no 6, p. 801-807Article in journal (Refereed) Published
Abstract [en]

Background: Pathological complete response (pCR) after neoadjuvant therapy in rectal cancer is correlated with improved survival. There is limited knowledge on the incidence of pCR at a national level with uniform guidelines. The aim of this prospective register-based study was to investigate the incidence and outcome of pCR in relation to neoadjuvant therapy in a national cohort. Method: All patients abdominally operated for rectal cancer between 2007 and 2012 (n = 7885) were selected from The Swedish Colorectal Cancer Register. Twenty-six per cent (n = 2063) had neoadjuvant therapy with either long or short course radiotherapy with amp;gt;4 weeks delay with the potential to achieve pCR. The primary endpoints were pCR and survival in relation to neoadjuvant therapy. Results: Complete eradication of the luminal tumor, ypTO was found in 161 patients (8%). In 83% of the ypTO the regional lymph nodes were tumor negative (ypTONO), 12% had 1-3 positive lymph nodes (ypTON1) and 4% had more than three positive lymph nodes (ypTON2). There was significantly greater survival with ypTO compared to ypT+ (hazard ratio 0.38 (C.I 0.25-0.58)) and survival was significantly greater in patients with ypTONO compared to ypT0N1-2 (hazard ratio 0.36 (C.I 0.15-0.86)). In ypTO, cT3-4 tumors had the greater risk of node-positivity. The added use of chemotherapy resulted in 10% ypTO compared to 5.1% in the group without chemotherapy (p amp;lt; 0.00004). Conclusion: Luminal pathological complete response occurred in 8%, 16% of them had tumor positive nodes. The survival benefit of luminal complete response is dependent upon nodal involvement status. (C) 2016 Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2016
Keywords
Rectal cancer; Complete response; Lymph nodes; Neoadjuvant treatment
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:liu:diva-130432 (URN)10.1016/j.ejso.2016.03.013 (DOI)000379559300007 ()27146960 (PubMedID)
Available from: 2016-08-07 Created: 2016-08-05 Last updated: 2017-05-02
Sjödahl, J., Walter, S., Johansson, E., Ingemansson, A., Ryn, A.-K. & Hallböök, O. (2015). Combination therapy with biofeedback, loperamide, and stool-bulking agents is effective for the treatment of fecal incontinence in women - a randomized controlled trial. Scandinavian Journal of Gastroenterology, 50(8), 965-974
Open this publication in new window or tab >>Combination therapy with biofeedback, loperamide, and stool-bulking agents is effective for the treatment of fecal incontinence in women - a randomized controlled trial
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2015 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 50, no 8, p. 965-974Article in journal (Refereed) Published
Abstract [en]

Objective. Biofeedback and medical treatments have been extensively used for moderate fecal incontinence (FI). There is limited data comparing and combining these two treatments. The objective of this study was to evaluate the effect of biofeedback and medical treatments, separately and in combination. Material and methods. Sixty-four consecutive female patients, referred to a tertiary centre for FI, were included. The patients were randomized to start with either biofeedback (4-6 months) or medical treatment with loperamide and stool-bulking agents (2 months). Both groups continued with a combination of treatments, i.e. medical treatment was added to biofeedback and vice versa. A two-week prospective bowel symptom diary and anorectal physiology were evaluated at baseline, after single-and combination treatments. Results. Fifty-seven patients completed the study. Median number of leakage episodes during two weeks decreased from 6 to 3 (p less than 0.0001) from baseline to completion. The patients showed a significant (1) decrease in number of leakages without forewarning (p = 0.04); (2) decrease in number of stools with urgency (p = 0.001); (3) decrease in number of loose stool consistency; and (4) an increase in rectal sensory thresholds, both for maximum tolerable rectal pressure and first sensation (less than 0.01). The combination treatment was superior to both single treatments in terms of symptoms and functions. There was no significant difference between the two groups at any time point. Conclusions. The combination therapy with biofeedback and medical treatment is effective for symptom relief in FI. The symptom improvement was associated with improved fecal consistency, reduced urgency, and increased rectal sensory thresholds.

Place, publisher, year, edition, pages
TAYLOR and FRANCIS LTD, 2015
Keywords
anorectal manometry; biofeedback; incontinence; pelvic floor exercises
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:liu:diva-121926 (URN)10.3109/00365521.2014.999252 (DOI)000361323200005 ()25892434 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland

Available from: 2015-10-13 Created: 2015-10-12 Last updated: 2017-12-01
Harle, K., Lindgren, M. & Hallböök, O. (2015). Experience of living with an enterocutaneous fistula. Journal of Clinical Nursing, 24(15-16), 2175-2183
Open this publication in new window or tab >>Experience of living with an enterocutaneous fistula
2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 15-16, p. 2175-2183Article in journal (Refereed) Published
Abstract [en]

Aims and objectives. The purpose of this study was to describe patients experiences of living with an enterocutaneous fistula. Background. An enterocutaneous fistula is a complex and serious illness that usually occurs as a complication from surgery or spontaneously as a result of an underlying disease. The illness is demanding both physically and mentally and causes substantial medical and nursing problems for the afflicted individual. Design. A descriptive design with a qualitative approach. Methods. In-depth interviews were performed with nine participants who had experiences of living with an enterocutaneous fistula. The analysis was conducted using descriptive phenomenology according to Giorgi. Results. The essence of this study was that living with an enterocutaneous fistula is about handling an illness that causes several limitations in daily life and the following five themes emerged from the data: restrictions in daily life, approaches to illness, emotions, dependence and need of support. A constant fear of leakage from the fistula appliance, being dependent on intravenous fluids and being dependent on health care professionals caused isolation and social restriction. Conclusions. The participants had many strategies for handling their illness. By being well trained, engaged and having a positive and understanding approach, health care professionals can encourage hope, motivation and self-care. This can lead to decreased dependence and help the patient to better handle their illness. Relevance to clinical practice. The competence of health care professionals is essential in the care of patients with an enterocutaneous fistula.

Place, publisher, year, edition, pages
Wiley: 12 months, 2015
Keywords
enterocutaneous fistula; experience; nursing; phenomenology; Sweden
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-121136 (URN)10.1111/jocn.12857 (DOI)000359259100012 ()25959706 (PubMedID)
Available from: 2015-09-08 Created: 2015-09-08 Last updated: 2017-12-04
Elawa, S., Hallböök, O., Myrelid, P. & Zdolsek, J. (2015). Intestinal obstruction following harvest of VRAM-flap for reconstruction of a large perineal defect. Case Reports in Plastic Surgery and Hand Surgery, 2(3-4), 88-91
Open this publication in new window or tab >>Intestinal obstruction following harvest of VRAM-flap for reconstruction of a large perineal defect
2015 (English)In: Case Reports in Plastic Surgery and Hand Surgery, ISSN 2332-0885, Vol. 2, no 3-4, p. 88-91Article in journal (Refereed) Published
Abstract [en]

A patient with locally advanced adenocarcinoma of the rectum was operated with abdominoperineal resection and perineal reconstruction with a vertical rectus abdominis musculocutaneous flap. Six days postoperatively, there was herniation of the small bowel, between the anterior and posterior rectus sheaths, to a subcutaneous location.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2015
Keywords
Vertical rectus abdominis musculocutaneous flap, perineal defect, rectal
National Category
Surgery Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-126099 (URN)10.3109/23320885.2015.1102640 (DOI)
Available from: 2016-03-21 Created: 2016-03-14 Last updated: 2018-03-20
Floodeen, H., Lindgren, R., Hallböök, O. & Matthiessen, P. (2014). Evaluation of Long-term Anorectal Function After Low Anterior Resection: A 5-Year Follow-up of a Randomized Multicenter Trial. Diseases of the Colon & Rectum, 57(10), 1162-1168
Open this publication in new window or tab >>Evaluation of Long-term Anorectal Function After Low Anterior Resection: A 5-Year Follow-up of a Randomized Multicenter Trial
2014 (English)In: Diseases of the Colon & Rectum, ISSN 0012-3706, E-ISSN 1530-0358, Vol. 57, no 10, p. 1162-1168Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Anorectal function after rectal surgery with low anastomosis is often impaired. Outcome of long-term anorectal function is poorly understood but may improve over time. OBJECTIVE: We evaluated anorectal function 5 years after low anterior resection for cancer with regard to whether patients had a temporary stoma at initial resection. The objective of this study was to assess changes in anorectal function over time by comparing the results with anorectal function 1 year after rectal resection. DESIGN: This study was a secondary end point of a randomized, multicenter controlled trial. SETTINGS: The study was conducted at 21 Swedish hospitals performing rectal cancer surgery from 1999 to 2005. PATIENTS: Patients included were those operated on with low anterior resection. INTERVENTIONS: Patients were randomly assigned to receive or not receive a defunctioning stoma. MAIN OUTCOME MEASURES: We evaluated anorectal function in patients who were initially randomly assigned to the defunctioning stoma or no stoma group, who had been free of stoma for 5 years, by means of using a standardized patient questionnaire. Questions addressed stool frequency, urgency, fragmentation of bowel movements, evacuation difficulties, incontinence, lifestyle alterations, and patient preference regarding permanent stoma formation. Results were compared with the same patient cohort at 1-year follow-up. RESULTS: A total of 123 patients answered the bowel function questionnaire (65 in the no-stoma group and 58 in the stoma group). No differences were found between groups regarding the number of passed stools, need for medication to open the bowel, evacuation difficulties, incontinence, and urgency. General well-being was significantly better in the no-stoma group (p = 0.033). Comparison with anorectal function at 1 year showed no further changes over time. LIMITATIONS: The study was based on a limited sample size (n = 123) and formed a secondary end point of a randomized trial. CONCLUSIONS: Anorectal function was impaired for many patients, but the temporary presence of a defunctioning stoma after rectal resection did not affect long-term outcome. Anorectal function did not change between 1-year and 5-year follow-up.

Place, publisher, year, edition, pages
Lippincott, Williams andamp; Wilkins / Springer Verlag (Germany), 2014
Keywords
Anorectal function; Defunctioning stoma; Long-term follow-up; Rectal cancer
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-111445 (URN)10.1097/DCR.0000000000000197 (DOI)000341970500002 ()25203371 (PubMedID)
Note

Funding Agencies|Orebro County Council (Orebro, Sweden)

Available from: 2014-10-21 Created: 2014-10-17 Last updated: 2017-12-05
Floodeen, H., Hallböök, O., Rutegard, J., Sjödahl, R. & Matthiessen, P. (2013). Early and late symptomatic anastomotic leakage following low anterior resection of the rectum for cancer: are they different entities?. Colorectal Disease, 15(3), 334-340
Open this publication in new window or tab >>Early and late symptomatic anastomotic leakage following low anterior resection of the rectum for cancer: are they different entities?
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2013 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 15, no 3, p. 334-340Article in journal (Refereed) Published
Abstract [en]

Aim The aim of the study was to compare patients with symptomatic anastomotic leakage following low anterior resection of the rectum (LAR) for cancer diagnosed during the initial hospital stay with those in whom leakage was diagnosed after hospital discharge. Method Forty-five patients undergoing LAR (n=234) entered into a randomized multicentre trial (NCT 00636948), who developed symptomatic anastomotic leakage, were identified. A comparison was made between patients diagnosed during the initial hospital stay on median postoperative day 8 (early leakage, EL; n=27) and patients diagnosed after hospital discharge at median postoperative day 22 (late leakage, LL; n=18). Patient characteristics, operative details, postoperative course and anatomical localization of the leakage were analysed. Results Leakage from the circular stapler line of an end-to-end anastomosis was more common in EL, while leakage from the stapler line of the efferent limb of the J-pouch or side-to-end anastomosis tended to be more frequent in LL (P=0.057). Intra-operative blood loss (P=0.006) and operation time (P=0.071) were increased in EL compared with LL. On postoperative day 5, EL performed worse than LL with regard to temperature (P=0.021), oral intake (P=0.006) and recovery of bowel activity (P=0.054). Anastomotic leakage was diagnosed most often by a rectal contrast study in EL and by CT scan in LL. The median initial hospital stay was 28days for EL and 10days for LL (Pandlt;0.001). Conclusion The present study has demonstrated that symptomatic anastomotic leakage can present before and after hospital discharge and raises the question of whether early and late leakage after LAR may be different entities.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013
Keywords
Symptomatic anastomotic leakage, early leakage, late leakage, low anterior resection of the rectum, postoperative course, hospital stay
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-90671 (URN)10.1111/j.1463-1318.2012.03195.x (DOI)000315519300022 ()
Note

Funding Agencies|Research Committee, Orebro County Council, Orebro, Sweden||

Available from: 2013-04-03 Created: 2013-04-03 Last updated: 2017-12-06
Runström, B., Hallböök, O., Nyström, P., Sjödahl, R. & Olaison, G. (2013). Outcome of 132 consecutive reconstructive operations for intestinal fistula--staged operation without primary anastomosis improved outcome in retrospective analysis. Scandinavian Journal of Surgery, 102(3), 152-157
Open this publication in new window or tab >>Outcome of 132 consecutive reconstructive operations for intestinal fistula--staged operation without primary anastomosis improved outcome in retrospective analysis
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2013 (English)In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 102, no 3, p. 152-157Article in journal (Refereed) Published
Abstract [en]

AIM

To study factors that influenced healing and survival after attempted closure of enterocutaneous fistula.

MATERIAL AND METHODS:

Retrospective analysis of prospective data concerning 101 patients operated on 132 instances for 110 enterocutaneous fistulae at two hospitals.

RESULTS:

In all, 96 (87%) of the 110 fistulae healed and 92 (91%) patients survived. A total of 9 patients with unhealed fistula died. Multivariate analysis revealed jaundice as an independent factor for both death and failed closure and operation without anastomosis as an independent positive factor for healing. Failure rate was lower after an operation with stoma without anastomosis (6 of 43, 14%) than after an operation with anastomosis (30 of 89, 34%) p = 0.0213. Of the 36 instances with unhealed fistula, 13 (36%) could be ascribed to inadvertent bowel lesions at the reconstructive operation. In addition, univariate analysis revealed that patients with previous multiple laparotomies or with multiple operations for enterocutaneous fistula healed less likely and had higher mortality. A low serum albumin, high white blood cell count, high C-reactive protein concentration, high fistula output, total parenteral nutrition, and operation for recurrent fistula were associated with death together with long operation time and operative bleeding, both indicators of surgical complexity. Over time, staged surgery avoiding anastomosis increased from 27% to 57%. Mortality decreased from 12% to 6%, and healing increased from 73% to 94%.

CONCLUSIONS:

Chronic inflammation, malnutrition, and liver failure causing an impaired healing capacity are important reasons for failure. Staged operation without primary anastomosis may allow the patient to reverse this condition and improve outcome. The high surgical complexity is a negative factor that requires careful planning of the operation.

Place, publisher, year, edition, pages
Sage Publications, 2013
Keywords
Surgery; bowel; fistula; anastomosis; stoma; enterocutaneous; wound healing; liver failure
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-107130 (URN)10.1177/1457496913490452 (DOI)000335583200004 ()23963028 (PubMedID)
Available from: 2014-06-05 Created: 2014-06-05 Last updated: 2017-12-05Bibliographically approved
Bojmar, L., Karlsson, E., Ellegard, S., Olsson, H., Björnsson, B., Hallböök, O., . . . Sandström, P. (2013). The Role of MicroRNA-200 in Progression of Human Colorectal and Breast Cancer. PLoS ONE, 8(12), 84815
Open this publication in new window or tab >>The Role of MicroRNA-200 in Progression of Human Colorectal and Breast Cancer
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2013 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 12, p. 84815-Article in journal (Refereed) Published
Abstract [en]

The role of the epithelial-mesenchymal transition (EMT) in cancer has been studied extensively in vitro, but involvement of the EMT in tumorigenesis in vivo is largely unknown. We investigated the potential of microRNAs as clinical markers and analyzed participation of the EMT-associated microRNA-200 ZEB E-cadherin pathway in cancer progression. Expression of the microRNA-200 family was quantified by real-time RT-PCR analysis of fresh-frozen and microdissected formalin-fixed paraffin-embedded primary colorectal tumors, normal colon mucosa, and matched liver metastases. MicroRNA expression was validated by in situ hybridization and after in vitro culture of the malignant cells. To assess EMT as a predictive marker, factors considered relevant in colorectal cancer were investigated in 98 primary breast tumors from a treatment-randomized study. Associations between the studied EMTmarkers were found in primary breast tumors and in colorectal liver metastases. MicroRNA-200 expression in epithelial cells was lower in malignant mucosa than in normal mucosa, and was also decreased in metastatic compared to non-metastatic colorectal cancer. Low microRNA-200 expression in colorectal liver metastases was associated with bad prognosis. In breast cancer, low levels of microRNA-200 were related to reduced survival and high expression of microRNA-200 was predictive of benefit from radiotheraphy. MicroRNA-200 was associated with ER positive status, and inversely correlated to HER2 and overactivation of the PI3K/AKT pathway, that was associated with high ZEB1 mRNA expression. Our findings suggest that the stability of microRNAs makes them suitable as clinical markers and that the EMT-related microRNA-200 - ZEB - E-cadherin signaling pathway is connected to established clinical characteristics and can give useful prognostic and treatment-predictive information in progressive breast and colorectal cancers.

Place, publisher, year, edition, pages
Public Library of Science, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103717 (URN)10.1371/journal.pone.0084815 (DOI)000328745100188 ()
Available from: 2014-01-24 Created: 2014-01-24 Last updated: 2017-12-06
Crafoord, K., Brynhildsen, J., Hallböök, O. & Kjölhede, P. (2012). Pelvic organ prolapse and anorectal manometry: a prospective study. Urogynaecologia International Journal, 26(1), 12-16
Open this publication in new window or tab >>Pelvic organ prolapse and anorectal manometry: a prospective study
2012 (English)In: Urogynaecologia International Journal, ISSN 1121-3086, E-ISSN 2038-8314, Vol. 26, no 1, p. 12-16Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to evaluate associations between anal sphincter pressure and stage of prolapse and bowel and prolapse symptoms among women undergoing prolapse surgery and to determine whether anal sphincter pressure could predict symptomatic and anatomical outcomes of prolapse surgery. Fortytwo women with pelvic organ prolapse (POP) stage 2-3 were included in this prospective longitudinal study. Pre- and postoperative evaluation by means of a symptom questionnaire, clinical examination and anorectal manometry. The vaginal prolapse surgery included at the very least posterior colporrhaphy. Analysis of variance and covariance and logistic regression models were used for statistical analyses. The anal sphincter pressure at rest and squeeze was significantly lower in women with the symptom vaginal protrusion than in the women without the symptom. No associations were found between anal sphincter pressure and the extent or degree of prolapse or subjective and anatomical outcomes of POP surgery. The prolapse symptom vaginal protrusion is associated with a low anal sphincter pressure but the anal sphincter pressure does not seem to predict the outcome of POP surgery, neither regarding symptoms nor anatomy.

Place, publisher, year, edition, pages
PAGEPress, 2012
Keywords
anorectal manometry, bowel dysfunction, outcome of surgery, POP surgery, prolapse symptom
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-89952 (URN)10.4081/uij.2012.e4 (DOI)
Available from: 2013-03-12 Created: 2013-03-12 Last updated: 2017-12-06
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