Skip to main content
Erschienen in: Annals of Surgical Oncology 9/2021

03.01.2021 | Translational Research

Clinical Importance of CD200 Expression in Colorectal Liver Metastasis

verfasst von: Yasuko Matsuo, MD, Masayuki Sho, MD, PhD, FACS, Takeo Nomi, MD, PhD, Daisuke Hokuto, MD, PhD, Takahiro Yoshikawa, MD, PhD, Naoki Kamitani, MD, Kota Nakamura, MD, Yosuke Iwasa, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2021

Einloggen, um Zugang zu erhalten

Abstract

Background

Approximately 30% of patients diagnosed with colorectal cancer (CRC) develop liver metastases. We evaluated the role of CD200, a potent immunosuppressive molecule, in colorectal liver metastases (CRLM).

Methods

We examined 110 patients who underwent curative liver resection for CRLM at our institution between 2000 and 2016. Based on the results of immunohistochemical analysis, the patients were divided into high-CD200 (n = 47) and low-CD200 (n = 63) expression groups. The relationships between CD200 expression and various clinicopathological outcomes were investigated.

Results

The overall survival (OS) of patients in the high-CD200 group was significantly worse than that in the low-CD200 group (p = 0.009). Multivariate analysis showed that the independent prognostic factors in CRLM were maximum tumor size > 30 mm (p = 0.002), preoperative carcinoembryonic antigen level > 20 ng/mL (p < 0.001), primary CRC N2–3 (p = 0.049), and high-CD200 expression (p = 0.004). Furthermore, CD4+, CD8+, and CD45RO+ tumor-infiltrating lymphocytes in CRLM were significantly higher in the low-CD200 group than in the high-CD200 group (p = 0.005, p = 0.001, and p < 0.001, respectively). In addition, patients who had received preoperative chemotherapy had higher CD200 expression than those who had not received preoperative chemotherapy, and OS was significantly worse in patients in the high-CD200 group who had received preoperative chemotherapy.

Conclusions

CD200 expression was an independent prognostic factor in CRLM. CD200 may play a critical role in tumor immunity in CRLM, and can therefore be used as a potential therapeutic target in CRLM.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics, 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.CrossRefPubMed Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics, 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.CrossRefPubMed
2.
Zurück zum Zitat Manfredi S, Lepage C, Hatem C, Coatmeur O, Faivre J, Bouvier AM. Epidemiology and management of liver metastases from colorectal cancer. Ann Surg. 2006;244:254–9.PubMedPubMedCentralCrossRef Manfredi S, Lepage C, Hatem C, Coatmeur O, Faivre J, Bouvier AM. Epidemiology and management of liver metastases from colorectal cancer. Ann Surg. 2006;244:254–9.PubMedPubMedCentralCrossRef
3.
Zurück zum Zitat Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2013;14:1208–15.PubMedCrossRef Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2013;14:1208–15.PubMedCrossRef
4.
Zurück zum Zitat Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008;371:1007–16.PubMedPubMedCentralCrossRef Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008;371:1007–16.PubMedPubMedCentralCrossRef
5.
Zurück zum Zitat Pan W, Huang S, Zhang J, et al. Heterogeneity-related anticancer therapy response differences in metastatic colon carcinoma: new hints to tumor-site-based personalized cancer therapy. Hepatogastroenterology. 2013;60:1927–34.PubMed Pan W, Huang S, Zhang J, et al. Heterogeneity-related anticancer therapy response differences in metastatic colon carcinoma: new hints to tumor-site-based personalized cancer therapy. Hepatogastroenterology. 2013;60:1927–34.PubMed
6.
Zurück zum Zitat Lan H, Jin K, Xie B, et al. Heterogeneity between primary colon carcinoma and paired lymphatic and hepatic metastases. Mol Med Rep. 2012;6:1057–68.PubMedCrossRef Lan H, Jin K, Xie B, et al. Heterogeneity between primary colon carcinoma and paired lymphatic and hepatic metastases. Mol Med Rep. 2012;6:1057–68.PubMedCrossRef
7.
Zurück zum Zitat Vermaat JS, Nijman IJ, Koudijs MJ, et al. Primary colorectal cancers and their subsequent hepatic metastases are genetically different: implications for selection of patients for targeted treatment. Clin Cancer Res. 2012;18:688–99.PubMedCrossRef Vermaat JS, Nijman IJ, Koudijs MJ, et al. Primary colorectal cancers and their subsequent hepatic metastases are genetically different: implications for selection of patients for targeted treatment. Clin Cancer Res. 2012;18:688–99.PubMedCrossRef
8.
Zurück zum Zitat Yamamoto S, Tanaka K, Takeda K, et al. Patients with CD133-negative colorectal liver metastasis have a poor prognosis after hepatectomy. Ann Surg Oncol. 2014;21:1853–61.PubMedCrossRef Yamamoto S, Tanaka K, Takeda K, et al. Patients with CD133-negative colorectal liver metastasis have a poor prognosis after hepatectomy. Ann Surg Oncol. 2014;21:1853–61.PubMedCrossRef
9.
Zurück zum Zitat Aref S, Azmy E, El-Gilany AH. Upregulation of CD200 is associated with regulatory T cell expansion and disease progression in multiple myeloma. Hematol Oncol. 2017;35:51–7.PubMedCrossRef Aref S, Azmy E, El-Gilany AH. Upregulation of CD200 is associated with regulatory T cell expansion and disease progression in multiple myeloma. Hematol Oncol. 2017;35:51–7.PubMedCrossRef
10.
Zurück zum Zitat Moreaux J, Hose D, Reme T, et al. CD200 is a new prognostic factor in multiple myeloma. Blood. 2006;108:4194–7.PubMedCrossRef Moreaux J, Hose D, Reme T, et al. CD200 is a new prognostic factor in multiple myeloma. Blood. 2006;108:4194–7.PubMedCrossRef
11.
Zurück zum Zitat Tonks A, Hills R, White P, et al. CD200 as a prognostic factor in acute myeloid leukaemia. Leukemia. 2007;21:566–8.PubMedCrossRef Tonks A, Hills R, White P, et al. CD200 as a prognostic factor in acute myeloid leukaemia. Leukemia. 2007;21:566–8.PubMedCrossRef
12.
Zurück zum Zitat Damiani D, Tiribelli M, Raspadori D, et al. Clinical impact of CD200 expression in patients with acute myeloid leukemia and correlation with other molecular prognostic factors. Oncotarget. 2015;6:30212–21.PubMedPubMedCentralCrossRef Damiani D, Tiribelli M, Raspadori D, et al. Clinical impact of CD200 expression in patients with acute myeloid leukemia and correlation with other molecular prognostic factors. Oncotarget. 2015;6:30212–21.PubMedPubMedCentralCrossRef
13.
Zurück zum Zitat Wright GJ, Jones M, Puklavec MJ, Brown MH, Barclay AN. The unusual distribution of the neuronal/lymphoid cell surface CD200 (OX2) glycoprotein is conserved in humans. Immunology. 2001;102:173–9.PubMedPubMedCentralCrossRef Wright GJ, Jones M, Puklavec MJ, Brown MH, Barclay AN. The unusual distribution of the neuronal/lymphoid cell surface CD200 (OX2) glycoprotein is conserved in humans. Immunology. 2001;102:173–9.PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Hoek RM, Ruuls SR, Murphy CA, et al. Down-regulation of the macrophage lineage through interaction with OX2 (CD200). Science. 2000;290:1768–71.PubMedCrossRef Hoek RM, Ruuls SR, Murphy CA, et al. Down-regulation of the macrophage lineage through interaction with OX2 (CD200). Science. 2000;290:1768–71.PubMedCrossRef
15.
Zurück zum Zitat Memarian A, Nourizadeh M, Masoumi F, et al. Upregulation of CD200 is associated with Foxp3+ regulatory T cell expansion and disease progression in acute myeloid leukemia. Tumour Biol. 2013;34:531–42.PubMedCrossRef Memarian A, Nourizadeh M, Masoumi F, et al. Upregulation of CD200 is associated with Foxp3+ regulatory T cell expansion and disease progression in acute myeloid leukemia. Tumour Biol. 2013;34:531–42.PubMedCrossRef
16.
Zurück zum Zitat Gorczynski RM, Lee L, Boudakov I. Augmented induction of CD4 + CD25 + Treg using monoclonal antibodies to CD200R. Transplantation. 2005;79:1180–3.PubMedCrossRef Gorczynski RM, Lee L, Boudakov I. Augmented induction of CD4 + CD25 + Treg using monoclonal antibodies to CD200R. Transplantation. 2005;79:1180–3.PubMedCrossRef
17.
Zurück zum Zitat Gorczynski L, Chen Z, Hu J, et al. Evidence that an OX-2-positive cell can inhibit the stimulation of type 1 cytokine production by bone marrow-derived B7-1 (and B7-2)-positive dendritic cells. J Immunol. 1999;162:774–81.PubMed Gorczynski L, Chen Z, Hu J, et al. Evidence that an OX-2-positive cell can inhibit the stimulation of type 1 cytokine production by bone marrow-derived B7-1 (and B7-2)-positive dendritic cells. J Immunol. 1999;162:774–81.PubMed
18.
Zurück zum Zitat Mahadevan D, Lanasa MC, Farber C, et al. Phase I study of samalizumab in chronic lymphocytic leukemia and multiple myeloma: blockade of the immune checkpoint CD200. J Immunother Cancer. 2019;7:227.PubMedPubMedCentralCrossRef Mahadevan D, Lanasa MC, Farber C, et al. Phase I study of samalizumab in chronic lymphocytic leukemia and multiple myeloma: blockade of the immune checkpoint CD200. J Immunother Cancer. 2019;7:227.PubMedPubMedCentralCrossRef
19.
Zurück zum Zitat Erin N, Tanrıöver G, Curry A, Akman M, Duymuş O, Gorczynski R. CD200fc enhances anti-tumoral immune response and inhibits visceral metastasis of breast carcinoma. Oncotarget. 2018;9:19147–58.PubMedPubMedCentralCrossRef Erin N, Tanrıöver G, Curry A, Akman M, Duymuş O, Gorczynski R. CD200fc enhances anti-tumoral immune response and inhibits visceral metastasis of breast carcinoma. Oncotarget. 2018;9:19147–58.PubMedPubMedCentralCrossRef
20.
Zurück zum Zitat Erin N, Podnos A, Tanriover G, et al. Bidirectional effect of CD200 on breast cancer development and metastasis, with ultimate outcome determined by tumor aggressiveness and a cancer-induced inflammatory response. Oncogene. 2015;34:3860–70.PubMedCrossRef Erin N, Podnos A, Tanriover G, et al. Bidirectional effect of CD200 on breast cancer development and metastasis, with ultimate outcome determined by tumor aggressiveness and a cancer-induced inflammatory response. Oncogene. 2015;34:3860–70.PubMedCrossRef
21.
Zurück zum Zitat Liu JQ, Talebian F, Wu L, et al. A critical role for CD200R signaling in limiting the growth and metastasis of CD200+ melanoma. J Immunol. 2016;197:1489–97.PubMedCrossRef Liu JQ, Talebian F, Wu L, et al. A critical role for CD200R signaling in limiting the growth and metastasis of CD200+ melanoma. J Immunol. 2016;197:1489–97.PubMedCrossRef
22.
Zurück zum Zitat Talebian F, Liu JQ, Liu Z, et al. Melanoma cell expression of CD200 inhibits tumor formation and lung metastasis via inhibition of myeloid cell functions. PLoS ONE. 2012;7:e31442.PubMedPubMedCentralCrossRef Talebian F, Liu JQ, Liu Z, et al. Melanoma cell expression of CD200 inhibits tumor formation and lung metastasis via inhibition of myeloid cell functions. PLoS ONE. 2012;7:e31442.PubMedPubMedCentralCrossRef
23.
Zurück zum Zitat Stumpfova M, Ratner D, Desciak EB, Eliezri YD, Owens DM. The immunosuppressive surface ligand CD200 augments the metastatic capacity of squamous cell carcinoma. Cancer Res. 2010;70:2962–72.PubMedPubMedCentralCrossRef Stumpfova M, Ratner D, Desciak EB, Eliezri YD, Owens DM. The immunosuppressive surface ligand CD200 augments the metastatic capacity of squamous cell carcinoma. Cancer Res. 2010;70:2962–72.PubMedPubMedCentralCrossRef
24.
Zurück zum Zitat Li L, Tian Y, Shi C, Zhang H, Zhou Z. Over-expression of CD200 predicts poor prognosis in cutaneous squamous cell carcinoma. Med Sci Monit. 2016;22:1079–84.PubMedPubMedCentralCrossRef Li L, Tian Y, Shi C, Zhang H, Zhou Z. Over-expression of CD200 predicts poor prognosis in cutaneous squamous cell carcinoma. Med Sci Monit. 2016;22:1079–84.PubMedPubMedCentralCrossRef
25.
Zurück zum Zitat Bisgin A, Meng WJ, Adell G, Sun XF. Interaction of CD200 Overexpression on tumor cells with CD200R1 overexpression on stromal cells: an escape from the host immune response in rectal cancer patients. J Oncol. 2019;2019:5689464.PubMedPubMedCentralCrossRef Bisgin A, Meng WJ, Adell G, Sun XF. Interaction of CD200 Overexpression on tumor cells with CD200R1 overexpression on stromal cells: an escape from the host immune response in rectal cancer patients. J Oncol. 2019;2019:5689464.PubMedPubMedCentralCrossRef
26.
27.
Zurück zum Zitat Inoue T, Sho M, Yasuda S, et al. HVEM expression contributes to tumor progression and prognosis in human colorectal cancer. Anticancer Res. 2015;35:1361–7.PubMed Inoue T, Sho M, Yasuda S, et al. HVEM expression contributes to tumor progression and prognosis in human colorectal cancer. Anticancer Res. 2015;35:1361–7.PubMed
28.
Zurück zum Zitat Hokuto D, Sho M, Yamato I, et al. Clinical impact of herpesvirus entry mediator expression in human hepatocellular carcinoma. Eur J Cancer. 2015;51:157–65.PubMedCrossRef Hokuto D, Sho M, Yamato I, et al. Clinical impact of herpesvirus entry mediator expression in human hepatocellular carcinoma. Eur J Cancer. 2015;51:157–65.PubMedCrossRef
29.
Zurück zum Zitat Ohtani H. Focus on TILs: prognostic significance of tumor infiltrating lymphocytes in human colorectal cancer. Cancer Immun. 2007;7:4.PubMedPubMedCentral Ohtani H. Focus on TILs: prognostic significance of tumor infiltrating lymphocytes in human colorectal cancer. Cancer Immun. 2007;7:4.PubMedPubMedCentral
30.
Zurück zum Zitat Pages F, Kirilovsky A, Mlecnik B, et al. In situ cytotoxic and memory T cells predict outcome in patients with early-stage colorectal cancer. J Clin Oncol. 2009;27:5944–51.PubMedCrossRef Pages F, Kirilovsky A, Mlecnik B, et al. In situ cytotoxic and memory T cells predict outcome in patients with early-stage colorectal cancer. J Clin Oncol. 2009;27:5944–51.PubMedCrossRef
31.
Zurück zum Zitat Katz SC, Bamboat ZM, Maker AV, et al. Regulatory T cell infiltration predicts outcome following resection of colorectal cancer liver metastases. Ann Surg Oncol. 2013;20:946–55.PubMedCrossRef Katz SC, Bamboat ZM, Maker AV, et al. Regulatory T cell infiltration predicts outcome following resection of colorectal cancer liver metastases. Ann Surg Oncol. 2013;20:946–55.PubMedCrossRef
32.
Zurück zum Zitat Camus M, Tosolini M, Mlecnik B, et al. Coordination of intratumoral immune reaction and human colorectal cancer recurrence. Cancer Res. 2009;69:2685–93.PubMedCrossRef Camus M, Tosolini M, Mlecnik B, et al. Coordination of intratumoral immune reaction and human colorectal cancer recurrence. Cancer Res. 2009;69:2685–93.PubMedCrossRef
33.
Zurück zum Zitat Galon J, Costes A, Sanchez-Cabo F, et al. Type, density, and location of immune cells within human colorectal tumors predict clinical outcome. Science. 2006;313:1960–4.PubMedCrossRef Galon J, Costes A, Sanchez-Cabo F, et al. Type, density, and location of immune cells within human colorectal tumors predict clinical outcome. Science. 2006;313:1960–4.PubMedCrossRef
34.
Zurück zum Zitat Sideras K, Galjart B, Vasaturo A, et al. Prognostic value of intra-tumoral CD8(+)/FoxP3(+) lymphocyte ratio in patients with resected colorectal cancer liver metastasis. J Surg Oncol. 2018;118:68–76.PubMedPubMedCentralCrossRef Sideras K, Galjart B, Vasaturo A, et al. Prognostic value of intra-tumoral CD8(+)/FoxP3(+) lymphocyte ratio in patients with resected colorectal cancer liver metastasis. J Surg Oncol. 2018;118:68–76.PubMedPubMedCentralCrossRef
35.
Zurück zum Zitat Berthel A, Zoernig I, Valous NA, et al. Detailed resolution analysis reveals spatial T cell heterogeneity in the invasive margin of colorectal cancer liver metastases associated with improved survival. Oncoimmunology. 2017;6:e1286436.PubMedPubMedCentralCrossRef Berthel A, Zoernig I, Valous NA, et al. Detailed resolution analysis reveals spatial T cell heterogeneity in the invasive margin of colorectal cancer liver metastases associated with improved survival. Oncoimmunology. 2017;6:e1286436.PubMedPubMedCentralCrossRef
36.
Zurück zum Zitat Naito Y, Saito K, Shiiba K, et al. CD8+ T cells infiltrated within cancer cell nests as a prognostic factor in human colorectal cancer. Cancer Res. 1998;58:3491–4.PubMed Naito Y, Saito K, Shiiba K, et al. CD8+ T cells infiltrated within cancer cell nests as a prognostic factor in human colorectal cancer. Cancer Res. 1998;58:3491–4.PubMed
37.
Zurück zum Zitat Pages F, Berger A, Camus M, et al. Effector memory T cells, early metastasis, and survival in colorectal cancer. N Engl J Med. 2005;353:2654–66.PubMedCrossRef Pages F, Berger A, Camus M, et al. Effector memory T cells, early metastasis, and survival in colorectal cancer. N Engl J Med. 2005;353:2654–66.PubMedCrossRef
38.
Zurück zum Zitat Ricci-Vitiani L, Lombardi DG, Pilozzi E, et al. Identification and expansion of human colon-cancer-initiating cells. Nature. 2007;445:111–5.PubMedCrossRef Ricci-Vitiani L, Lombardi DG, Pilozzi E, et al. Identification and expansion of human colon-cancer-initiating cells. Nature. 2007;445:111–5.PubMedCrossRef
39.
Zurück zum Zitat Todaro M, Alea MP, Di Stefano AB, et al. Colon cancer stem cells dictate tumor growth and resist cell death by production of interleukin-4. Cell Stem Cell. 2007;1:389–402.PubMedCrossRef Todaro M, Alea MP, Di Stefano AB, et al. Colon cancer stem cells dictate tumor growth and resist cell death by production of interleukin-4. Cell Stem Cell. 2007;1:389–402.PubMedCrossRef
40.
Zurück zum Zitat Zeuner A, Todaro M, Stassi G, De Maria R. Colorectal cancer stem cells: from the crypt to the clinic. Cell Stem Cell. 2014;15:692–705.PubMedCrossRef Zeuner A, Todaro M, Stassi G, De Maria R. Colorectal cancer stem cells: from the crypt to the clinic. Cell Stem Cell. 2014;15:692–705.PubMedCrossRef
42.
Zurück zum Zitat Kawasaki BT, Farrar WL. Cancer stem cells, CD200 and immunoevasion. Trends Immunol. 2008;29:464–8.PubMedCrossRef Kawasaki BT, Farrar WL. Cancer stem cells, CD200 and immunoevasion. Trends Immunol. 2008;29:464–8.PubMedCrossRef
43.
Zurück zum Zitat Zhang SS, Huang ZW, Li LX, Fu JJ, Xiao B. Identification of CD200+ colorectal cancer stem cells and their gene expression profile. Oncol Rep. 2016;36:2252–60.PubMedCrossRef Zhang SS, Huang ZW, Li LX, Fu JJ, Xiao B. Identification of CD200+ colorectal cancer stem cells and their gene expression profile. Oncol Rep. 2016;36:2252–60.PubMedCrossRef
44.
Zurück zum Zitat Jung YS, Vermeer PD, Vermeer DW, et al. CD200: association with cancer stem cell features and response to chemoradiation in head and neck squamous cell carcinoma. Head Neck. 2015;37:327–35.PubMedCrossRef Jung YS, Vermeer PD, Vermeer DW, et al. CD200: association with cancer stem cell features and response to chemoradiation in head and neck squamous cell carcinoma. Head Neck. 2015;37:327–35.PubMedCrossRef
45.
Zurück zum Zitat Imai K, Yamashita YI, Miyamoto Y, et al. The predictors and oncological outcomes of repeat surgery for recurrence after hepatectomy for colorectal liver metastases. Int J Clin Oncol. 2018;23:908–16.PubMedCrossRef Imai K, Yamashita YI, Miyamoto Y, et al. The predictors and oncological outcomes of repeat surgery for recurrence after hepatectomy for colorectal liver metastases. Int J Clin Oncol. 2018;23:908–16.PubMedCrossRef
46.
Zurück zum Zitat Neal CP, Nana GR, Jones M, et al. Repeat hepatectomy is independently associated with favorable long-term outcome in patients with colorectal liver metastases. Cancer Med. 2017;6:331–8.PubMedPubMedCentralCrossRef Neal CP, Nana GR, Jones M, et al. Repeat hepatectomy is independently associated with favorable long-term outcome in patients with colorectal liver metastases. Cancer Med. 2017;6:331–8.PubMedPubMedCentralCrossRef
48.
Zurück zum Zitat Leach DR, Krummel MF, Allison JP. Enhancement of antitumor immunity by CTLA-4 blockade. Science. 1996;271:1734–6.PubMedCrossRef Leach DR, Krummel MF, Allison JP. Enhancement of antitumor immunity by CTLA-4 blockade. Science. 1996;271:1734–6.PubMedCrossRef
49.
50.
Zurück zum Zitat Fridman WH, Pagès F, Sautes-Fridman C, Galon J. The immune contexture in human tumours: impact on clinical outcome. Nat Rev Cancer. 2012;12:298–306.PubMedCrossRef Fridman WH, Pagès F, Sautes-Fridman C, Galon J. The immune contexture in human tumours: impact on clinical outcome. Nat Rev Cancer. 2012;12:298–306.PubMedCrossRef
Metadaten
Titel
Clinical Importance of CD200 Expression in Colorectal Liver Metastasis
verfasst von
Yasuko Matsuo, MD
Masayuki Sho, MD, PhD, FACS
Takeo Nomi, MD, PhD
Daisuke Hokuto, MD, PhD
Takahiro Yoshikawa, MD, PhD
Naoki Kamitani, MD
Kota Nakamura, MD
Yosuke Iwasa, MD
Publikationsdatum
03.01.2021
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2021
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-09471-w

Weitere Artikel der Ausgabe 9/2021

Annals of Surgical Oncology 9/2021 Zur Ausgabe

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Deutlich weniger Infektionen: Wundprotektoren schützen!

08.05.2024 Postoperative Wundinfektion Nachrichten

Der Einsatz von Wundprotektoren bei offenen Eingriffen am unteren Gastrointestinaltrakt schützt vor Infektionen im Op.-Gebiet – und dient darüber hinaus der besseren Sicht. Das bestätigt mit großer Robustheit eine randomisierte Studie im Fachblatt JAMA Surgery.

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.