在接受腔外科手术的晚期癌症患者中评估身体健康和身体组成 - - 一项试点队列研究
Marina Looby1,2, Lewis Matthews3, Charles T West1,2,3
1Academic Surgery, Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
概括
心肺运动测试 (CPET) 可以预测晚期盆腔癌患者的重大术后并发症. 在CPET期间降低峰值功率输出与较高的发病风险有关,这表明其在预康复策略中的潜在作用.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 生理学 生理学 生理学
背景情况:
- 局部发达的骨盆恶性瘤需要进行广泛的手术,具有高风险.
- 多种模式的治疗,包括多器官外腔切除,对于治愈至关重要.
- 身体构成和心肺运动测试 (CPET) 在此类手术后的主要发病率的预后价值未得到充分研究.
研究的目的:
- 评估身体组成和CPET的综合预后价值,以评估为患有晚期盆腔癌外腔手术的患者在医院内的主要发病率.
- 调查身体组成指标与身体健康之间的关联.
- 确定CPET参数是否可以预测术后并发症.
主要方法:
- 分析了局部晚期结直肠和门癌症的患者队列.
- 术前CPET按照国家指导方针进行.
- 使用CT扫描的骨肌肉指数 (SMI) 和骨肌肉辐射减弱 (SM-RA) 来评估身体组成.
- 主要发病率被定义为Clavien-Dindo分类≥3a.
主要成果:
- 在低SMI或SM-RA的患者中观察到体能降低.
- 在无氧值和峰值时,SMI是氧气吸收的强有力的预测因素.
- 17.3%的患者经历了严重的术后并发症.
- 降低峰值功率输出 (<1.5W/kg) 与增加主要发病率风险 (OR=2.6,p=0.012) 有显著关联.
结论:
- 在这种患者群体中,CPET显示出预测住院主要发病率的潜力.
- CPET与人体成分之间的相互作用需要进一步研究.
- 综合评估可以指导预康复干预,并改善患者的治疗结果.
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