结肠癌的教科书结局:对整体存活率和无病存活率的影响
Juan Jesús Rubio García1,2,3, F Mauri Barberá1, C Villodre Tudela1,2
1Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario de Alicante, Alicante, Spain.
Langenbeck's archives of surgery
|May 30, 2023
概括
教科书结局 (TO) 是对结肠癌 (CC) 患者理想手术结果的质量指标. 实现TO与改善整体存活率有关,突出了其在瘤治疗中的价值.
科学领域:
- 手术质量管理手术质量管理
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 教科书结果 (TO) 是一种质量管理工具,用于评估理想的外科结果.
- 这项研究评估了选择性结肠癌 (CC) 手术中的TO成就.
研究的目的:
- 为了确定在接受选择性结肠癌手术的患者中教科书结果 (TO) 的率.
- 分析实现TO和患者生存结果之间的关联.
主要方法:
- 从2012年至2016年,对564名接受了选择性CC手术 (不包括直肠癌) 的患者进行了回顾性分析.
- TO定义包括R0切除,≥12个淋巴结,没有严重并发症,没有长期停留,没有再入院,没有30天死亡率.
- 统计分析评估了TO的实现及其与总体和无病生存时间的相关性.
主要成果:
- 教科书结局 (TO) 在49.8%的患者中实现.
- 女性性别,高级T阶段 (T3/T4) 和腹腔镜方法独立地与实现TO相关.
- 实现TO的患者的整体存活率显著提高 (p=0.008),但没有无病存活率 (p=0.303).
结论:
- 教科书结果 (TO) 作为一个有价值和可解释的工具来评估瘤手术结果.
- 在结肠癌患者中,TO成绩是改善整体存活率的重要预测因素.
- 这些发现支持TO在CC手术的质量管理和生存预测中的实用性.
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