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教科书结局有助于长期预后在患有食道状细胞癌的老年患者
Chihiro Matsumoto1, Masaaki Iwatsuki1, Chishou Mitsuura1
1Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan.
Annals of gastroenterological surgery
|September 4, 2024
概括
教科书结局 (TO) 预测了老年患者食道状细胞癌 (ESCC) 手术后的生存率. 实现TO与更好的长期生存有关,而非TO则表明结果较差.
科学领域:
- 在瘤学瘤学.
- 外科手术的结果
- 老年医学 老年医学
背景情况:
- 教科书结局 (TO) 是一个综合测量手术质量的指标.
- 食道状细胞癌 (ESCC) 是一个重要的健康问题,特别是在老年人群中.
- 治愈切除是ESCC的主要治疗方式.
研究的目的:
- 调查教科书结局 (TO) 对接受ESCC治疗切除的老年患者的长期生存的预测价值.
- 为了评估实现TO和ESCC食道切除术后患者的结果之间的关联.
- 为了确定影响老年ESCC患者的存活率的因素,以治愈意图治疗.
主要方法:
- 在2005年至2020年期间,对105名老年患者进行了ESCC治疗性食道切除术的回顾性分析.
- 根据10个预定义的TO参数,患者被分为TO和非TO组.
- 使用统计分析,包括多变量考克斯回归来评估TO与整体存活率之间的关联.
主要成果:
- 教科书结局 (TO) 在26%的患者中实现,TO组年龄大得多.
- 最难实现的TO参数是"没有住院时间≥21天".
- 非TO组的患者的整体存活时间明显缩短 (p=0.03). 淋巴结转移 (HR 3.42) 和非TO (HR 2.37) 独立地与低生存率有关.
结论:
- 教科书结局 (TO) 作为一个有价值的预测器的生存后,治疗性食道切除术在老年患者ESCC.
- 实现TO与改善的长期生存结果有关.
- 这些发现强调了对老年ESCC患者的手术护理全面质量评估的重要性.
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