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结直肠癌肝转移腹腔镜肝切除临床风险评分的验证:一项为期10年的观察性随访研究。

Validation of clinical risk scores for laparoscopic liver resections of colorectal liver metastases: A 10-year observed follow-up study.

作者信息

Barkhatov Leonid, Fretland Åsmund A, Kazaryan Airazat M, Røsok Bård I, Brudvik Kristoffer W, Waage Anne, Bjørnbeth Bjørn A, Sahakyan Mushegh A, Edwin Bjørn

机构信息

Intervention Centre, Oslo University Hospital - Rikshospitalet, Oslo, Norway.

Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.

出版信息

J Surg Oncol. 2016 Nov;114(6):757-763. doi: 10.1002/jso.24391. Epub 2016 Jul 29.

Abstract

OBJECTIVE

The aim of this study was to validate clinical risk scores in patients underwent laparoscopic resection of colorectal liver metastases (CLM) with 5 years follow-up or more, and assess 5- and 10-year actual survival in this group.

METHODS

A total of 516 laparoscopic liver resections were performed in 406 patients with CLM between February 1998 and September 2015. A follow-up of 5 and 10 years could be assessed in 144 and 29 patients, respectively. The Fong score, pre- and postoperative Basingstoke Predictive Index (BPI), Nordlinger score, and Iwatsuki score were validated.

RESULTS

Five- and ten-year cancer-related actual survival was 54% and 32%, respectively. The Fong score, pre- and postoperative BPI and the Nordlinger score divided patients into risk groups with significant difference in survival between the groups. However, predicted 5-year survival rates were lower than the actual 5-year survival (mean difference in 17%,13%, 20%, and 30%, respectively).

CONCLUSION

The Fong score, pre- and postoperative BPI and the Nordlinger score systems can be used to predict survival for laparoscopically operated patients in the era of multimodal-treatment after adjusting of survival rates. The actual five- and 10-year survival after laparoscopic resection of CLM is similar to results previously published for open liver resection. J. Surg. Oncol. 2016;114:757-763. © 2016 Wiley Periodicals, Inc.

摘要

目的

本研究旨在验证接受腹腔镜切除结直肠癌肝转移(CLM)且随访5年及以上患者的临床风险评分,并评估该组患者的5年和10年实际生存率。

方法

1998年2月至2015年9月期间,对406例CLM患者共进行了516例腹腔镜肝切除术。分别对144例和29例患者进行了5年和10年的随访。对Fong评分、术前和术后的贝辛斯托克预测指数(BPI)、诺德林格评分和岩月评分进行了验证。

结果

5年和10年癌症相关实际生存率分别为54%和32%。Fong评分、术前和术后BPI以及诺德林格评分将患者分为不同风险组,组间生存率有显著差异。然而,预测的5年生存率低于实际5年生存率(平均差异分别为17%、13%、20%和30%)。

结论

Fong评分、术前和术后BPI以及诺德林格评分系统在调整生存率后可用于预测多模式治疗时代腹腔镜手术患者的生存率。CLM腹腔镜切除术后的实际5年和10年生存率与先前发表的开放性肝切除术结果相似。《外科肿瘤学杂志》2016年;114:757 - 763。©2016威利期刊公司。

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