After reading this, I was wondering, if there was a definite plan months ago for surgery, or maybe not, if there was, why was Tiffany’s weak physical condition not treated aggresively? She has lost so much blood which means very low hemoglobin, her cachexia was also very evident with the extreme weight loss. The “ eat more” approach we heard she was told in the video where she revealed her scan results and surgery in December is not enough imo, she needs transfusions iron intravenously and intravenous protein intakes. And those 8 weeks without treatment but “ wait and see” approach makes one wonder. We are not hearing the real story here.
“ Survival analysis revealed that high preoperative hemoglobin levels were predictive of better OS and patients with higher serum albumin levels showed better RFS. These results underscore the need for better preoperative conditioning to nor- malize patients’ hemoglobin levels (blood management) by giving iron infusions and other supplements, thereby reducing the need for blood transfusion in perioperative settings [20]. A high preoperative serum protein level is necessary for improving patients’ nutritional status. It is therefore important to ensure adequate caloric intake, either orally or intravenously [21]. All these perioperative measures are aligned with ERAS programs, which include numerous methods for improving preoperative health, postoperative mobilization, and digestion in patients, especially those with a long history of cancer. The earlier conditioning of the patient is begun, the better the outcome may be. This leaves room for future trials [13, 22].
With regard to tumor-associated factors, we show that a positive nodal status and positive resection margins are strong predictors for decreased OS and RFS, which is in good accordance with previous studies [6, 15]. Moreover, we could veriify that primary tumors have better OS and RFS than recurrent cancer [23]. In addition, our data of the subgroup analysis suggest that a limited metastatic situation like singular metastasis in the liver and lung is not significantly associated with OS if an R0 resection is possible. However, as an indication of earlier tumor relapse, it might be of interest for future studies in order to extend the surgical indication. Therefore, individual approaches should be discussed in interdisciplinar”
Same thoughts passed through my mind..