教科书结局有助于老年结直肠癌患者的长期预后
Yuto Maeda1, Masaaki Iwatsuki2, Chisho Mitsuura1
1Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan.
Langenbeck's archives of surgery
|June 24, 2023
概括
老年结直肠癌 (CRC) 患者的教科书结局 (TO) 对长期生存有显著影响. 在治愈性结直肠切除术后实现TO与更好的整体存活率 (OS) 和无复发存活率 (RFS) 有关.
科学领域:
- 在瘤学瘤学.
- 手术的质量 手术的质量
- 老年医学 老年医学
背景情况:
- 教科书结局 (TO) 定义了理想的手术和术后质量措施.
- 对接受结肠直肠癌 (CRC) 手术的老年患者的生存期TO的影响尚未得到充分证实.
研究的目的:
- 为了确定TO是否与老年CRC患者的治愈性结直肠切除术后的长期结果有关.
- 在这个人口群体中研究TO对生存的预测价值.
主要方法:
- 对接受治疗性CRC手术的老年患者 (75岁以上) 的回顾性分析 (2005年3月至2016年12月).
- 通过5个参数定义TO:在6周内进行手术,彻底切除,淋巴结 (LN) 产量≥12,无静脉瘤,没有不良结果.
- 实现TO的患者与未达到TO的患者之间的结果比较 (nTO).
主要成果:
- 在43.0%的患者中实现了TO.
- 没有达到TO (nTO) 的患者的5年整体存活率 (OS) (60.8% vs. 77.8%) 和无复发存活率 (RFS) (50.8% vs. 69.6%) 显着较差.
- nTO是更糟糕的OS (HR 2.04) 和RFS (HR 1.72) 的独立预测因素.
结论:
- 教科书结局 (TO) 是术后发病率和预后的一个有价值的预测指标.
- 在老年CRC患者治疗性结直肠切除术后实现TO与改善的长期存活率有关.
- TO可以指导老年瘤外科手术的质量改善举措.
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