对局部晚期结肠癌的新辅助化疗对术后并发症的影响
Andrew Lynch1, Rodrigo Arean-Sanz1, Ana Sofia Ore1
1Colon and Rectal Surgery Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Langenbeck's archives of surgery
|September 19, 2023
概括
与前期手术相比,局部晚期结肠癌 (LAC) 的新辅助化疗 (NAC) 并没有增加重大术后并发症. 这一发现支持NAC作为选择LAC患者的安全选择.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道手术 胃肠道手术
背景情况:
- 新辅助化疗 (NAC) 是局部晚期结肠癌 (LAC) 的替代方案.
- 有限的数据存在于30天的术后结果,将NAC与LAC的前期手术进行比较.
研究的目的:
- 为了比较经过前期手术的LAC患者与NAC之间的30天重大术后并发症.
- 评估NAC在LAC手术结果的背景下的安全性.
主要方法:
- 来自ACS-NSQIP数据库 (2016-2020) 的11,498名LAC患者的分析.
- 前期切除术 (96.2%) 和NAC (3.8%) 组之间的比较.
- 倾向性得分匹配 (PSM) 和多变量逻辑回归来评估30天的主要术后并发症.
主要成果:
- 在PSM分析中,NAC和前期手术组之间的重大并发症没有显著差异.
- NAC与30天重大术后并发症的增加没有显著关联.
- 确定的并发症风险因素包括T4阶段,年龄较大,男性性别,黑人种族,吸烟,依赖状态,严重的慢性肺炎,低蛋白血症和手术前输血;腹腔镜和机器人手术具有保护性.
结论:
- 新辅助化疗不会增加局部晚期结肠癌患者出现重大术后并发症的风险.
- 对于精选的LAC患者来说,NAC是一种可行的选择,它在短期术后结果方面显示出与前期手术相比的安全性.
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