肠镜疗法与手术切除对于患有结直肠神经内分泌瘤的老年患者
1Department of Endoscopy Center, The First People's Hospital of Kunshan, Suzhou, China.
Surgical endoscopy
|August 30, 2024
概括
与手术切除 (SR) 相比,内镜治疗 (ET) 为患有结直肠神经内分泌瘤 (CRNET) 的老年患者提供了更好的长期存活率. 这项研究强调了ET作为这群人群的优越治疗选择.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 老年医学 老年医学
背景情况:
- 大肠直肠神经内分泌瘤 (CRNETs) 用内镜治疗 (ET) 或手术切除 (SR) 来治疗.
- 对于患有CRNET的老年患者 (≥65岁) 的最佳治疗策略尚不清楚.
- 在老年CRNET患者中,对ET与SR的长期结局进行比较需要进行调查.
研究的目的:
- 为了比较老年患者的长期整体存活率 (OS) 和癌症特异性存活率 (CSS),使用ET治疗的CRNETs与SR.
- 确定影响该患者群体生存结果的独立风险因素.
主要方法:
- 从监测,流行病学和最终结果数据库 (2000-2020) 中对患有CRNET的老年患者 (≥65岁) 的回顾性分析.
- 倾向分数匹配 (PSM) 来控制ET和SR组之间的选择偏差.
- 卡普兰-梅尔分析和考克斯比例危险模型用于评估生存结果和风险因素.
主要成果:
- 总共分析了2214名患者 (1417名ET,797名SR).
- 在PSM后,与SR相比,ET表现出明显更好的OS (HR 0.56) 和CSS (HR 0.21).
- ET组显示出更高的1年,3年和5年的OS和CSS率 (P < 0.001).
- OS和CSS的独立风险因素包括年龄,性别,学年级,婚姻状况和治疗方式.
结论:
- 内镜治疗 (ET) 与患有结直肠神经内分泌瘤的老年患者的优异长期整体存活率和癌症特异性存活率有关.
- 在65岁及以上的患者中,ET应被认为是CRNET的首选治疗方式.
- 治疗方式,以及人口和临床因素,显著影响老年CRNET患者的存活率.
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