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超声引导下肝转移瘤消融术后结直肠癌长期生存的预测因素

Predictive factors of long-term colorectal cancer survival after ultrasound-controlled ablation of hepatic metastases.

作者信息

Hernández-Socorro Carmen Rosa, Saavedra Pedro, Ramírez Felipe José, Bohn Sarmiento Uriel, Ruiz-Santana Sergio

机构信息

Unidad de Ecografía Intervencionista, Servicio de Radiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, España.

Departamento de Matemáticas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España.

出版信息

Med Clin (Barc). 2017 Apr 21;148(8):345-350. doi: 10.1016/j.medcli.2016.11.024. Epub 2017 Jan 7.

Abstract

BACKGROUND AND OBJECTIVE

The risk factors associated to long-term survival were assessed in patients with liver metastases of colorectal carcinoma undergoing ablative therapies.

PATIENTS AND METHODS

Single-centre cohort study, retrospectively analysed and prospectively collected consecutive patients with unresectable metastatic liver disease of colorectal carcinoma treated with ablative therapies between 1996 and 2013. Factors associated with survival time were identified using Cox's proportional hazard model with time-dependent covariates. A forward variable selection based on Akaike information criterion was performed. Relative risk and 95% confidence intervals for each factor were calculated. Statistical significance was set as P<.05.

RESULTS

Seventy-five patients with liver metastases of colorectal cancer, with a mean age of 65.6 (10.3) underwent 106 treatments. Variables selected were good quality of life (RR 0.308, 95% CI 0.150-0.632) and tumour extension (RR 3.070, 95% CI 1.776-5.308). The median overall survival was 18.5 months (95% CI 17.4-24.4). The survival prognosis in median was 13.5 vs. 23.4 months for patients with and without tumour extension, and 23.0 vs. 12.8 months for patients with good and fair or poor quality of life, respectively.

CONCLUSIONS

Good quality of life and tumour extension were the only statistically significant predictors of long-term survival in patients of colorectal carcinoma with liver metastatic disease undergoing ablative treatment with ultrasound.

摘要

背景与目的

对接受消融治疗的结直肠癌肝转移患者的长期生存相关危险因素进行评估。

患者与方法

单中心队列研究,回顾性分析并前瞻性收集1996年至2013年间接受消融治疗的不可切除结直肠癌转移性肝病连续患者。使用具有时间依赖性协变量的Cox比例风险模型确定与生存时间相关的因素。基于赤池信息准则进行向前变量选择。计算每个因素的相对风险和95%置信区间。设定统计学显著性为P<0.05。

结果

75例结直肠癌肝转移患者,平均年龄65.6(10.3)岁,接受了106次治疗。选择的变量为生活质量良好(RR 0.308,95%CI 0.150 - 0.632)和肿瘤范围(RR 3.070,95%CI 1.776 - 5.308)。中位总生存期为18.5个月(95%CI 17.4 - 24.4)。有和无肿瘤范围的患者中位生存预后分别为13.5个月和23.4个月,生活质量良好和中等或较差的患者分别为23.0个月和12.8个月。

结论

生活质量良好和肿瘤范围是接受超声消融治疗的结直肠癌肝转移患者长期生存的仅有的具有统计学显著性的预测因素。

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