影响长期结果的危险因素在西格结肠癌与尿膀参与的长肠癌中
Vladimir Balaban1, Igor Sedakov2,3, Nikolay Bondarenko2,3
1Clinic of Colorectal and Minimally Invasive Surgery, Sechenov University, Moscow, Russia. balaban@kkmx.ru.
消极的切除边缘,避免严重的并发症,辅助化疗显著提高了sigmoid结肠癌患者与膀参与的生存率. 这些因素是改善这种复杂条件的长期结果的关键.
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:
- 带有尿道膀参与的西格结肠癌存在独特的外科手术挑战.
- 对于这些晚期病例,通常需要进行多胞体切除.
- 确定影响长期生存的因素对于患者管理至关重要.
研究的目的:
- 为了确定影响长期结果的风险因素,在患有西格结肠癌和尿膀参与的患者.
- 分析手术和辅助治疗对生存的影响.
- 为改善患者预后提供基于证据的建议.
主要方法:
- 对118名接受多切除的患者进行了回顾性队列研究.
- 2002年6月至2017年5月期间收集的数据.
- 单变量和多变量分析以确定生存结果的风险因素.
主要成果:
- 在91.6%的患者中实现了R0切除;8.5%的患者出现了严重的 (III-IV级) 并发症.
- 低局部无复发生存率,无病生存率和整体生存率的危险因素包括高的查尔森并发症指数 (CCI),严重并发症,阳性边缘,晚期,额外切除和缺乏辅助化疗.
- 辅助化疗仅在26.3%的患者中使用.
结论:
- 负切除边缘对于改善生存至关重要.
- 尽量减少严重的术后并发症 (Clavien-Dindo III-IV级) 对结果产生积极影响.
- 辅助化疗是提高这一患者群体的整体,无疾病和局部无复发生存的关键因素.
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