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低营养预后指数与IV期结直肠癌患者原发肿瘤姑息切除术后的不良生存相关。

Low nutritional prognostic index correlates with poor survival in patients with stage IV colorectal cancer following palliative resection of the primary tumor.

作者信息

Maeda Kiyoshi, Shibutani Masatsune, Otani Hiroshi, Nagahara Hisashi, Sugano Kenji, Ikeya Teturo, Kubo Naoshi, Amano Ryosuke, Kimura Kenjiro, Muguruma Kazuya, Tanaka Hiroaki, Hirakawa Kosei

机构信息

Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan,

出版信息

World J Surg. 2014 May;38(5):1217-22. doi: 10.1007/s00268-013-2386-x.

Abstract

BACKGROUND

We retrospectively investigated the prognostic significance of various clinicopathological factors and preoperative nutritional status to select patients with stage IV colorectal cancer (CRC) who will have a poor prognosis after palliative resection of the primary tumor.

METHODS

A total of 100 stage IV CRC patients who underwent palliative resection were enrolled. Various clinicopathological factors and Onodera's prognostic nutritional index (OPNI) were evaluated to identify any possible relationship with the prognosis.

RESULTS

At the time of the analysis, 83 patients had died, and the median survival time was 21 months. Of the 100 patients, 24 had primary tumor-related symptoms such as obstruction or bleeding. No significant correlation was noted between the OPNI and various clinicopathological factors. The multivariate analysis of patients without primary tumor-related symptoms revealed that the OPNI was an independent prognostic factor. The overall survival of the low-OPNI group was significantly worse than that of the high-OPNI group.

CONCLUSIONS

This retrospective study suggested that patients with a low OPNI may not be candidates for palliative resection, because it provides no survival benefit to these patients.

摘要

背景

我们进行了一项回顾性研究,以探究各种临床病理因素及术前营养状况对Ⅳ期结直肠癌(CRC)患者的预后意义,从而筛选出原发肿瘤姑息性切除术后预后较差的患者。

方法

共纳入100例行姑息性切除的Ⅳ期CRC患者。评估各种临床病理因素及小野寺预后营养指数(OPNI),以确定其与预后的可能关系。

结果

分析时,83例患者已死亡,中位生存时间为21个月。100例患者中,24例有梗阻或出血等原发肿瘤相关症状。OPNI与各种临床病理因素之间未发现显著相关性。对无原发肿瘤相关症状患者的多因素分析显示,OPNI是一个独立的预后因素。低OPNI组的总生存期明显差于高OPNI组。

结论

这项回顾性研究表明,OPNI低的患者可能不适合进行姑息性切除,因为这对这些患者没有生存益处。

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