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前列腺癌放射治疗后的直肠癌:一种倾向匹配分析
M Goldenshluger1, M A Abbas2, M Belkovsky1
1Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA.
概括
接受前列腺癌辐射治疗的患者几年后可能会患上继发性直肠癌 (SRC). 尽管需要进行更广泛的手术,但SRC患者的结局和生存率与原发性直肠癌 (PRC) 患者相似.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 辐射瘤学 辐射瘤学
背景情况:
- 用放射治疗原发性前列腺癌 (PPC) 的患者有第二次直肠癌 (SRC) 的风险增加.
- 对于SRC前列腺后辐射的临床表现,手术结果和瘤结果尚未确定.
研究的目的:
- 为了比较二次性直肠癌 (SRC) 的临床和病理特征,前列腺癌放射治疗后与初级直肠癌 (PRC).
- 评估和比较SRC和PRC患者之间的治疗结果,包括手术结果和整体存活率.
主要方法:
- 追溯性队列研究,利用2001-2021年电子病历的单变量和倾向匹配分析.
- 纳入标准:患有直肠癌 (RC) 的男性患者接受瘤切除,有或没有先前前列腺辐射;排除:放射治疗和RC诊断之间的间隔<3年.
- 主要结果指标:病理分析,术后并发症和整体存活率.
主要成果:
- 在1755名RC患者中,有50名 (2.9%) 患有SRC;分析了43名. 从放射治疗到SRC诊断的中位时间为8年.
- SRC患者年龄较大 (平均年龄为73.7岁而不是61.1岁),ASA得分较高,瘤较远.
- 与PRC患者相比,较少的SRC患者接受了新辅助疗法 (16.3%与44.8%相比),需要更广泛的手术 (例如,腹腔切除) 和较少的关节保护程序. 倾向匹配显示,瘤分化,分期或术后并发症没有差异. 在SRC和PRC组之间,6年总生存率相似 (53.2%和50.3%).
结论:
- 二次性直肠癌 (SRC) 可以在治疗前列腺癌 (PPC) 的放射治疗后长达10年发展.
- SRC患者通常比原发性直肠癌 (PRC) 患者更老,患有更多的并发性疾病,接受较少的新辅助疗法,并接受更广泛的手术,关节保存率较低.
- 尽管有手术和并发症差异,SRC患者的病理结果和整体存活率与PRC患者相似.
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