Yu Huichuan, Luo Yanxin, Peng Hui, Kang Liang, Huang Meijin, Luo Shuangling, Chen Wenhao, Yang Zihuan, Wang Jianping
Department of Colon and Rectum Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, China.
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, China.
Tumour Biol. 2015 Sep;36(10):8055-63. doi: 10.1007/s13277-015-3535-7. Epub 2015 May 15.
This study aimed to assess the association between postoperative body temperature and prognosis in patients with rectal cancer. Five hundred and seven patients with stage I to III rectal cancers were enrolled in the current study. Basal body temperature (BBT, measured at 6 am) and maximal body temperature (MBT) on each day after surgery were analyzed retrospectively. Patients were divided into two equal groups according to the median of BBT and MBT at each day. The primary end points were disease-free survival (DFS) and overall survival (OS). The univariate and multivariate analyses showed that patients with low D0-MBT (<37.4 °C) had lower 3-year DFS [adjusted hazard ratio (HR) 1.56 (95 % CI 1.08-2.24, P = 0.017)] as well as OS [adjusted HR 1.72 (95 % CI 1.05-2.82, P = 0.032)] rate as compared to those with high D0-MBT (>37.4 °C). In the subset of 318 patients with T3 stage tumor and the subgroup of 458 patients without blood transfusion as well, low D0-MBT continues to be an independent predictor of DFS/OS with an adjusted HR equal to 1.48 (95 % CI 1.02-2.24, P = 0.046)/1.68 (95 % CI 1.04-2.99, P = 0.048) and 1.45 (95 % CI 1.02-2.13, P = 0.048)/1.59 (95 % CI 1.01-2.74, P = 0.049), respectively. In addition, we found that patients have higher risk of 1-year recurrence if those were exhibiting low preoperative BBT (<36.6 °C) (17 vs. 10 %, P = 0.034). Low body temperature (D0-MBT < 37.4 °C) after surgery was an independent predictor of poor survival outcomes in patients with rectal cancer.
本研究旨在评估直肠癌患者术后体温与预后之间的关联。本研究纳入了507例I至III期直肠癌患者。对术后每日的基础体温(BBT,上午6点测量)和最高体温(MBT)进行回顾性分析。根据每日BBT和MBT的中位数将患者分为两组,每组人数相等。主要终点为无病生存期(DFS)和总生存期(OS)。单因素和多因素分析显示,与D0-MBT较高(>37.4°C)的患者相比,D0-MBT较低(<37.4°C)的患者3年DFS率[调整后风险比(HR)1.56(95%CI 1.08-2.24,P = 0.017)]和OS率[调整后HR 1.72(95%CI 1.05-2.82,P = 0.032)]更低。在318例T3期肿瘤患者亚组以及458例未输血患者亚组中,低D0-MBT仍然是DFS/OS的独立预测因素,调整后HR分别为1.48(95%CI 1.02-2.24,P = 0.046)/1.68(95%CI 1.04-2.99,P = 0.048)和1.45(95%CI 1.02-2.13,P = 0.048)/1.59(95%CI 1.01-2.74,P = 0.049)。此外,我们发现术前BBT较低(<36.6°C)的患者1年复发风险更高(17%对10%,P = 0.034)。术后低体温(D0-MBT < 37.4°C)是直肠癌患者生存结局不良的独立预测因素。