胃癌术后并发症的预后价值 胃癌术后并发症的预后价值
Lin-Fei Ren1, Yong-Hong Xu1, Jie-Gen Long1
1Department of General Surgery, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, China.
概括
术后并发症显著影响胃癌 (GC) 患者的预后,影响整体存活率和无病存活率. 积极管理并发症,特别是传染性并发症,对于改善手术GC患者的治疗结果至关重要.
科学领域:
- 在瘤学瘤学.
- 外科胃肠道外科手术
- 临床流行病学临床流行病学
背景情况:
- 在胃癌 (GC) 患者中,术后并发症的发生率越来越高.
- 关于这些并发症的预后影响的不确定性.
- 需要调查手术后并发症和彻底切除后患者结果之间的关系.
研究的目的:
- 调查术后并发症作为胃癌患者进行激进切除的预后因素的作用.
- 分析并发症对各种生存结果的影响,包括总生存率 (OS),无病生存率 (DFS),疾病特异性生存率 (DSS) 和无复发生存率 (RFS).
主要方法:
- 在PubMed,Embase和Cochrane图书馆数据库中进行系统的文献搜索.
- 包括29项研究,涉及33858名患者.
- 对生存终点的危险比率 (HR) 和95%信心区间 (CI) 的元分析;根据并发症类型分组分析.
主要成果:
- 术后并发症被确定为OS (HR=1.52),DFS (HR=1.71),DSS (HR=1.60) 和RFS (HR=1.26) 的独立预后因素.
- 腹腔内,解剖管泄漏和肺炎是最常见的并发症.
- 非传染性并发症与OS没有显著的关联 (HR=1.39).
结论:
- 手术后的并发症会对胃癌患者在彻底切除后的预后产生负面影响.
- 外科医生应该专注于积极管理并发症,特别是传染性并发症,以改善患者的治疗结果.
- 需要进一步关注管理并发症,以提高胃癌手术中的存活率.
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