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2 results on '"Helmiö M"'

1. Preoperative hemoglobin count and prognosis of esophageal cancer, a population-based nationwide study in Finland

Author

Jokela, E. M. (Ella M.K.), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Ohtonen, P. (Pasi), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Sihvo, E. (Eero), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Valtola, A. (Antti), Jokela, E. M. (Ella M.K.), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Ohtonen, P. (Pasi), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Sihvo, E. (Eero), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), and Valtola, A. (Antti)

Abstract

Background: The prognostic value of preoperative hemoglobin in patients undergoing esophagectomy is unknown. The aim of this study was to examine whether preoperative hemoglobin is associated with prognosis in patients undergoing esophagectomy for cancer. Materials and methods: This was a population-based nationwide retrospective cohort study in Finland, using Finnish National Esophago-Gastric Cancer Cohort (FINEGO). Esophagectomy patients with available preoperative hemoglobin measurement were included. Multivariable cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period of surgery, age at surgery, sex, comorbidity (Charlson Comorbidity Index), tumor histology, tumor stage, neoadjuvant therapy, type of surgery (minimally invasive or open) and annual hospital volume. Results: Of the 1313 patients, 932 (71.0%) were men and 799 (60.9%) had esophageal adenocarcinoma. Overall all-cause mortality was significantly higher in the lowest hemoglobin count tertile (HR 1.26 (1.07–1.47)) compared to the highest tertile, but this association was attenuated after adjustment for confounding. No differences were found between the preoperative hemoglobin groups in the adjusted analyses of 90-day all-cause, 5-year all-cause, and 5-year cancer-specific mortality. Conclusions: In this population-based nationwide study, preoperative hemoglobin count had no independent prognostic significance in esophageal cancer.

Published
2022

2. Validation of the individualized metabolic surgery score for bariatric procedure selection in the merged data of two randomized clinical trials (SLEEVEPASS and SM-BOSS).

Author

Saarinen I, Grönroos S, Hurme S, Peterli R, Helmiö M, Bueter M, Strandberg M, Wölnerhanssen BK, and Salminen P

Subjects
Humans, Weight Loss, Randomized Controlled Trials as Topic, Gastrectomy methods, Treatment Outcome, Diabetes Mellitus, Type 2 surgery, Obesity, Morbid surgery, Gastric Bypass methods, Bariatric Surgery, Laparoscopy methods
Abstract

Background: LSG and LRYGB are globally the most common bariatric procedures. IMS score categorizes T2D severity (mild, moderate, and severe) based on 4 independent preoperative predictors of long-term remission as follows: T2D duration, number of diabetes medications, insulin use, and glycemic control. IMS score has not been validated in a randomized patient cohort., Objectives: To assess the feasibility of individualized metabolic surgery (IMS) score in facilitating procedure selection between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) for patients with severe obesity and type 2 diabetes (T2D)., Setting: Merged individual patient-level 5-year data of 2 large randomized clinical trials (SLEEVEPASS and SM-BOSS [Swiss Multicenter Bypass or Sleeve Study])., Methods: IMS score was calculated for study patients and its performance was analyzed., Results: One hundred thirty-nine out of 155 patients with T2D had available preoperative data to calculate IMS score as follows: mild stage (n = 41/139), moderate stage (n = 77/139), severe stage (n = 21/139). At 5 years, 135 (87.1%, 67 LSG/68 LRYGB) were available for follow-up and 121 patients had both pre- and postoperative data. Diabetes remission rates according to preoperative IMS score were as follows: mild stage 87.5% (n = 14/16) after LSG and 85.7% (n = 18/21) after LRYGB (P = .999), moderate stage 42.9% (n = 15/35) and 45.2% (n = 14/31) (P = .999), and severe stage 18.2% (n = 2/11) and 0% (n = 0/7) (P = .497), respectively. The T2D remission rate varied significantly between the stages as follows: mild versus moderate odds ratio (OR) 8.3 (95% CI, 2.8-24.0; P < .001), mild versus severe OR 52.2 (95% CI 9.0-302.3; P < .001), and moderate versus severe OR 6.3 (95% CI, 1.3-29.8; P = .020)., Conclusions: In our study, remission rates of T2D were not statistically different after LSG and LRYGB among all patients and among patients with mild, moderate, and severe diabetes stratified by the IMS score. However, the study may be underpowered to detect differences due to small number of patients in each subgroup. IMS score seemed to be useful in predicting long-term T2D remission after bariatric surgery., (Copyright © 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2023
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