基于生存益处的胃切除术后修改教科书结果的评估:多中心观察研究
Xia Lin1,2, Wenbin Yu3, Wei Zhang2
1Department of General Surgery, The First Affiliated Hospital of the Third Military Medical University, Chongqing, China.
International journal of surgery (London, England)
|August 27, 2025
概括
在胃切除术患者中,修改的教科书结局 (mTO) 定义显著提高了生存率. 与标准的TO相比,这种综合性指标在评估外科手术质量和长期瘤结果方面具有优越的优势.
科学领域:
- 癌症学
- 改善外科手术的质量
- 胃癌手术
背景情况:
- 教科书结果 (TO) 是术后质量评估的关键指标.
- 对胃切除术的标准化定义是缺乏的.
- 这项研究引入并评估了胃癌手术的修改TO (mTO).
研究的目的:
- 评估胃切除术中修改教科书结果 (mTO) 的发生率.
- 评估mTO与长期癌症存活率之间的关联.
- 将mTO与标准TO的生存益处进行比较.
主要方法:
- 分析了来自七个中国大规模中心的连续接受治疗性胃切除术的患者 (n=2,608).
- 根据R0切除,淋巴结检索,没有严重并发症,短期住院,没有90天的死亡率或再入院.
- 主要结局:使用考克斯回归的mTO与5年总生存率 (OS) 和无病生存率 (DFS) 的关联.
主要成果:
- mTO的实现率为62. 4%,而TO为72. 0%.
- 实现mTO独立地与5年OS (HR0. 565) 和DFS (HR0. 561) 的显著降低风险相关.
- 在子组分析中,mTO与TO相比显示出更大的生存益处.
结论:
- 修改的教科书结果 (mTO) 是胃切除术中术后质量的更全面的指标.
- 获得mTO与改善长期癌症存活率密切相关.
- mTO提供了比标准TO定义更好的生存效益.
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