营养不良普遍查工具在预测激进囊切除术后结果中的作用
Ziv Savin1, Aviv Kupershmidt1, Dorel Phollan2
1Department of Urology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Surgical oncology
|June 9, 2023
概括
营养不良普遍查工具 (MUST) 可以预测接受激进囊切除术的患者的生存率. 高MUST分数表明死亡风险更高,建议在术前患者评估和营养规划中使用它.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 营养科学 营养科学
背景情况:
- 营养不良是手术患者的一个问题.
- 营养不良普遍查工具 (MUST) 使用BMI,体重减轻和急性疾病评估营养不良风险.
- 对于接受激进囊切除术 (RC) 的患者,MUST的预测价值尚未得到充分确立.
研究的目的:
- 评估MUST得分在预测急性囊切除术后患者的术后结果和预后方面的作用.
- 确定MUST得分是否可以识别患有并发症风险较高和RC后生存率较差的患者.
主要方法:
- 在2015年至2019年期间,对291名接受了激进囊切除术的患者进行了多中心的回顾性分析.
- 患者被分为低风险 (MUST 分数<1) 和中高风险 (MUST 分数≥1) 组.
- 使用卡普兰-梅尔曲线和考克斯回归分析来评估30天的并发症,癌症特异性存活率 (CSS) 和整体存活率 (OS).
主要成果:
- 在MUST风险组之间没有观察到基线特征或30天术后并发症的显著差异.
- 与低风险组 (76% CSS, 71% OS) 相比,中高MUST分数的患者在3年内显著降低了CSS (60%) 和OS (50%).
- 在多变量分析中,MUST分数为1或以上是总和癌症特异性死亡率的独立预测指标.
结论:
- 较高的MUST分数与急性囊切除术后患者的存活率降低有显著关联.
- 必须得分显示了作为一种有价值的手术前工具的潜力,用于识别有风险的患者并指导营养干预.
- 实施MUST查可以改善激进囊切除候选人的患者选择和管理策略.
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