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Dehlaghi Jadid, KavehORCID iD iconorcid.org/0000-0002-6671-7130
Publications (7 of 7) Show all publications
Dehlaghi Jadid, K. (2024). Long-term outcome, socioeconomic aspects and postoperative inflammatory response in minimally invasive rectal cancer surgery. (Doctoral dissertation). Örebro: Örebro University
Open this publication in new window or tab >>Long-term outcome, socioeconomic aspects and postoperative inflammatory response in minimally invasive rectal cancer surgery
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In Sweden, more than 2,200 individuals are diagnosed with rectal cancer each year and surgical resection is the cornerstone of treatment. Minimally invasive surgery (MIS) was introduced for abdominal rectal cancer resection in the 1990s. Proven advantages of MIS in the short term include less intraoperative bleeding, less postoperative pain, faster postoperative mobilization, and shorter hospital stay. Large randomized studies have also shown that MIS is not inferior to OPEN with regard to the oncological short-term or long-term outcome.

The aim of this thesis was to increase the knowledge of MIS from a Swedish perspective regarding long-term oncological outcome, socioeconomic aspects, and the postoperative inflammatory response in curative abdominal rectal cancer surgery.

Study I included all patients who were diagnosed with clinical stage I-III rectal cancer during 2010-2016. More than 8,300 patients were identified via the Swedish Colorectal Cancer Registry (SCRCR). The study had a so-called non-inferiority design and investigated overall 5-year survival. The results showed that survival was not worse in patients who underwent minimally invasive surgery in comparison to patients who underwent open surgery.

Study II included all patients who were diagnosed with pathological stage I-III cancer of the colon 2010-2016. More than 11,000 patients were identified via the SCRCR. The study was designed in the same way as Study I. The results demonstrated that minimally invasive surgery was not inferior to open surgery.

Study III analysed the potential impact of socioeconomic status, measured as level of education and household income, regarding the likelihood of receiving minimally invasive surgery. All patients who underwent curative abdominal rectal resection surgery during 2010-2016 were included. More than 8,000 patients were identified. The results showed that patients with the highest level of education and those in the highest income quartile were more likely to be operated on with minimally invasive technique.

Study IV analysed the inflammatory response, measured as serum C-reactive protein during postoperative days 1-5, in all 520 patients undergoing abdominal rectal resection in Örebro between 2011 and 2021. Following exclusions based on postoperative adverse events, 382 patients remained for final analysis. The study demonstrated a trend for a less pronounced inflammatory response in patients operated with robot-assisted laparoscopy compared with conventional laparoscopy.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2024. p. 70
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 286
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-110084 (URN)9789175295343 (ISBN)
Public defence
2024-02-02, Örebro universitet, Campus USÖ, X2502 (Tidefeltsalen), Södra Grev Rosengatan 32, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2023-12-07 Created: 2023-12-07 Last updated: 2024-02-16Bibliographically approved
Petersson, J., Matthiessen, P., Dehlaghi Jadid, K., Bock, D. & Angenete, E. (2024). Short-term results in a population based study indicate advantage for minimally invasive rectal cancer surgery versus open. BMC Surgery, 24(1), Article ID 52.
Open this publication in new window or tab >>Short-term results in a population based study indicate advantage for minimally invasive rectal cancer surgery versus open
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2024 (English)In: BMC Surgery, E-ISSN 1471-2482, Vol. 24, no 1, article id 52Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The aim of this study was to determine if minimally invasive surgery (MIS) for rectal cancer is non-inferior to open surgery (OPEN) regarding adequacy of cancer resection in a population based setting.

METHODS: All 9,464 patients diagnosed with rectal cancer 2012-2018 who underwent curative surgery were included from the Swedish Colorectal Cancer Registry.

PRIMARY OUTCOMES: Positive circumferential resection margin (CRM < 1 mm) and positive resection margin (R1). Non-inferiority margins used were 2.4% and 4%. SECONDARY OUTCOMES: 30- and 90-day mortality, clinical anastomotic leak, re-operation < 30 days, 30- and 90-day re-admission, length of stay (LOS), distal resection margin < 1 mm and < 12 resected lymph nodes. Analyses were performed by intention-to-treat using unweighted and weighted multiple regression analyses.

RESULTS: The CRM was positive in 3.8% of the MIS group and 5.4% of the OPEN group, risk difference -1.6% (95% CI -1.623, -1.622). R1 was recorded in 2.8% of patients in the MIS group and in 4.4% of patients in the OPEN group, risk difference -1.6% (95% CI -1.649, -1.633). There were no differences between the groups in adjusted unweighted and weighted analyses. All analyses demonstrated decreased mortality and re-admissions at 30 and 90 days as well as shorter LOS following MIS.

CONCLUSIONS: In this population based setting MIS for rectal cancer was non-inferior to OPEN regarding adequacy of cancer resection with favorable short-term outcomes.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Laparoscopic surgery, Minimally invasive surgery, Rectal cancer, Robotic surgery
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:oru:diva-111655 (URN)10.1186/s12893-024-02336-z (DOI)001161245200001 ()38341534 (PubMedID)2-s2.0-85184792417 (Scopus ID)
Funder
University of GothenburgSwedish Cancer Society, 19 0333 PjAnna-Lisa and Bror Björnsson Foundation
Note

Open access funding provided by University of Gothenburg. This study was supported by the Swedish Cancer Society 19 0333 Pj, ALF Sahlgrenska University Hospital, ‘Agreement concerning research and education of doctors’ ALFGBG-716581, Anna-Lisa and Bror Björnsson’s Foundation. 

Available from: 2024-02-21 Created: 2024-02-21 Last updated: 2024-02-26Bibliographically approved
Dehlaghi Jadid, K., Cao, Y., Petersson, J., Sjövall, A., Angenete, E. & Matthiessen, P. (2023). Long term oncological outcomes for minimally invasive surgery versus open surgery for colon cancer: A population-based nationwide study with a non-inferiority design. Colorectal Disease, 25(5), 954-963
Open this publication in new window or tab >>Long term oncological outcomes for minimally invasive surgery versus open surgery for colon cancer: A population-based nationwide study with a non-inferiority design
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2023 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 25, no 5, p. 954-963Article in journal (Refereed) Published
Abstract [en]

AIM: The study aimed to compare five-year overall survival in a national cohort of patients undergoing curative abdominal resection for colon cancer by minimally invasive surgery (MIS) or open (OPEN) technique.

METHODS: All patients diagnosed between 2010 and 2016 in Sweden with pathological UICC stage I-III colon cancer localized in the cecum, ascending colon, hepatic flexure or sigmoid colon, and those who underwent curative right sided hemicolectomy, sigmoid resection or high anterior resection by MIS or OPEN were included. Patients were identified in the Swedish Colorectal Cancer Registry from which all data was retrieved. The analyses were performed as intention-to-treat and the relationship between surgical technique (MIS or OPEN) and overall mortality within five years was analysed. For the primary research question a non-inferiority hypothesis was assumed with a statistical power of 90%, a one-side type I error of 2.5%, and a non-inferiority margin of 2%. For the secondary analyses, multilevel survival regression models with the patients matched by propensity scores were employed, adjusted for patient- and tumuor-related variables.

RESULTS: A total of 11605 pathological UICC cancer stage I-III patients were included with 3297 MIS (28.4%) and 8308 OPEN (71.6%) and were followed until December 31, 2020. The primary analysis demonstrated superiority for MIS compared to OPEN. The multilevel survival regression analyses confirmed that five-year overall survival was higher in MIS with a hazard ratio (HR) of 0.874 (95% confidence interval (CI): 0.791-0.965), and if excluding pT4, outcome was similar, with a HR of 0.847 (95% CI: 0.756-0.948).

CONCLUSION: This observational study demonstrated that MIS was favourable to OPEN with regard to five-year overall survival. These results support the use of laparoscopic colon cancer surgery in routine practise.

Place, publisher, year, edition, pages
Blackwell Publishing, 2023
Keywords
colon cancer, LAP, laparoscopy, long term outcome, minimally invasive surgery, MIS, non-inferiority, oncological outcome, overall survival, population based, propensity score
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-104137 (URN)10.1111/codi.16512 (DOI)000947019500001 ()36762443 (PubMedID)2-s2.0-85150627454 (Scopus ID)
Note

Funding agency:

Research Committee, Region Örebro County, Örebro

Available from: 2023-02-13 Created: 2023-02-13 Last updated: 2024-02-08Bibliographically approved
Petersson, J., Matthiessen, P., Dehlaghi Jadid, K., Bock, D. & Angenete, E. (2023). Short term results in a population based study indicate advantage for laparoscopic colon cancer surgery versus open. Scientific Reports, 13(1), Article ID 4335.
Open this publication in new window or tab >>Short term results in a population based study indicate advantage for laparoscopic colon cancer surgery versus open
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2023 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, no 1, article id 4335Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to compare LAP with OPEN regarding short-term mortality, morbidity and completeness of the cancer resection for colon cancer in a routine health care setting using population based register data. All 13,683 patients who were diagnosed 2012-2018 and underwent elective surgery for right-sided or sigmoid colon cancer were included from the Swedish Colorectal Cancer Registry and the National Patient Registry. Primary outcome was 30-day mortality. Secondary outcomes were 90-day mortality, length of hospital stay, reoperation, readmission and positive resection margin (R1). Weighted and unweighted multi regression analyses were performed. There were no difference in 30-day mortality: LAP (0.9%) and OPEN (1.3%) (OR 0.89, 95% CI 0.62-1.29, P = 0.545). The weighted analyses showed an increased 90-day mortality following OPEN, P < 0.001. Re-operations and re-admission were more frequent after OPEN and length of hospital stay was 2.9 days shorter following LAP (P < 0.001). R1 resections were significantly more common in the OPEN group in the unweighted and weighted analysis with P = 0.004 and P < 0.001 respectively. Therefore, the favourable short-term outcomes following elective LAP versus OPEN resection for colon cancer in routine health care indicate an advantage of laparoscopic surgery.

Place, publisher, year, edition, pages
Nature Publishing Group, 2023
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-105108 (URN)10.1038/s41598-023-30448-8 (DOI)000984357200029 ()36927758 (PubMedID)2-s2.0-85150312979 (Scopus ID)
Funder
University of GothenburgSwedish Cancer SocietyAnna-Lisa and Bror Björnsson Foundation
Note

Funding agency:

ALF Sahlgrenska University Hospital, 'Agreement concerning research and education of doctors' ALFGBG-716581

Available from: 2023-03-21 Created: 2023-03-21 Last updated: 2023-12-07Bibliographically approved
Dehlaghi Jadid, K., Cao, Y., Petersson, J., Angenete, E. & Matthiessen, P. (2022). Long term oncological outcomes for laparoscopic versus open surgery for rectal cancer: a population based nationwide non-inferiority study. Colorectal Disease, 24(11), 1308-1317
Open this publication in new window or tab >>Long term oncological outcomes for laparoscopic versus open surgery for rectal cancer: a population based nationwide non-inferiority study
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2022 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 24, no 11, p. 1308-1317Article in journal (Refereed) Published
Abstract [en]

AIM: The aim was to compare five-year overall survival in a national cohort of patients undergoing curative abdominal resection for rectal cancer by laparoscopic (LAP) or open (OPEN) technique.

METHODS: All patients diagnosed with clinical stage I-III rectal cancer and who underwent LAP or OPEN abdominal curative surgery between 2010 and 2016 in Sweden were retrieved from the Swedish Colorectal Cancer Registry. A non-inferiority study design was employed with a statistical power of 90%, a one-side type I error of 2.5%, and a non-inferiority margin of 2%. The analyses were performed as intention-to-treat and the relationship between surgical technique and overall mortality within five years was analyzed. Multilevel regression models with the patients matched by propensity scores adjusted for patient and tumour related variables.

RESULTS: A total of 8410 cancer stage I-III patients were included whereof 2094 LAP (24.9%) and 6316 underwent OPEN (74.9%) and were followed until December 31, 2020. Multivariable Cox regression demonstrated that five-year overall survival was higher in LAP; Hazard Ratio (HR): 0.877;(95% CI: 0.877-0.993). Outcome was similar when employing multiple imputation and propensity score matching. When excluding cT4 there was no difference; HR: 0.885;(95% CI: 0.790-1.033). At five years follow up, local recurrence was not different, 2.9% in LAP and 3.6% in OPEN (P=0.075), while metastatic disease was more frequent in OPEN, 19.6% compared with 15.6% in LAP (P<0.001).

CONCLUSIONS: This study demonstrated that LAP was not inferior to OPEN with regard to overall five-year survival. These results support the use of laparoscopic surgery.

Place, publisher, year, edition, pages
Blackwell Publishing, 2022
Keywords
Rectal cancer, laparoscopy, minimally invasive surgery, multiple imputation, non-inferiority, oncological outcome, population based, propensity score, survival
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:oru:diva-99524 (URN)10.1111/codi.16204 (DOI)000822846800001 ()35656573 (PubMedID)2-s2.0-85133674068 (Scopus ID)
Note

Funding agency:

Research Committee, Region Örebro County, Örebro OLL-964736

Available from: 2022-06-15 Created: 2022-06-15 Last updated: 2024-01-12Bibliographically approved
Dehlaghi Jadid, K., Gadan, S., Wallin, G., Nordenwall, C., Boman, S. E., Hed Myrberg, I. & Matthiessen, P.Does socio-economic status influence the choice of surgical techniquein abdominal rectal cancer surgery?.
Open this publication in new window or tab >>Does socio-economic status influence the choice of surgical techniquein abdominal rectal cancer surgery?
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(English)Manuscript (preprint) (Other academic)
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-110694 (URN)
Available from: 2024-01-12 Created: 2024-01-12 Last updated: 2024-01-12Bibliographically approved
Dehlaghi Jadid, K., Gadan, S., Wallin, G. & Matthiessen, P.Postoperative inflammatory response in patients undergoinglaparoscopic and robotic rectal cancer resection.
Open this publication in new window or tab >>Postoperative inflammatory response in patients undergoinglaparoscopic and robotic rectal cancer resection
(English)Manuscript (preprint) (Other academic)
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-110695 (URN)
Available from: 2024-01-12 Created: 2024-01-12 Last updated: 2024-01-12Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6671-7130

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