Suppr超能文献

对于横结肠癌患者,部分结肠切除术在肿瘤学上是否安全:一项基于大人群的研究。

Whether partial colectomy is oncologically safe for patients with transverse colon cancer: a large population-based study.

作者信息

Guan Xu, Zhao Zhixun, Yang Ming, Chen Haipeng, Chen Wei, Liu Zheng, Jiang Zheng, Chen Yinggang, Wang Guiyu, Wang Xishan

机构信息

Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Oncotarget. 2017 Sep 26;8(54):93236-93244. doi: 10.18632/oncotarget.21275. eCollection 2017 Nov 3.

Abstract

Due to special tumor location and technical difficulty of transverse colon cancer (TCC), partial colectomy (PC) is being widely applied in selected TCC patients, instead of extended hemicolectomy (HC). However, the oncological safety of this less aggressive surgical approach is not well studied. Here, we identified 10344 TCC patients from Surveillance, Epidemiology, and End-Results (SEER) database. The surgical treatment for those patients included PC and HC. Firstly, we compared lymph nodes evaluations between patients treated with HC and PC, including median number of nodes, the rate of nodes ≥ 12 and the rate of node positivity. Then, 5-year cancer specific survival (CSS) was obtained. Kaplan-Meier methods and Cox regression models were performed to assess the correlations between prognostic factors and long-term survival. Despite of less node examined by PC, the rate of node positivity was equal between PC and HC, suggesting node retrieval under PC was adequate to tumor stage. In addition, the 5-year CSS for patients who underwent PC were 67.5%, which was similar to patients who received HC (66.5%). The result after propensity score matching also confirmed the equivalent survival outcome between HC and PC. However, subgroup analyses showed that patients with tumor size ≥ 5 cm could not obtain survival benefit from PC. Furthermore, surgical approach was not considered as independent prognostic factor for TCC patients. Therefore, although PC is a less aggressive surgical approach, it should be a safe and feasible option for selected TCC patients.

摘要

由于横结肠癌(TCC)特殊的肿瘤位置和技术难度,部分结肠切除术(PC)正在广泛应用于选定的TCC患者,而非扩大半结肠切除术(HC)。然而,这种侵袭性较小的手术方法的肿瘤学安全性尚未得到充分研究。在此,我们从监测、流行病学和最终结果(SEER)数据库中识别出10344例TCC患者。这些患者的手术治疗包括PC和HC。首先,我们比较了接受HC和PC治疗的患者之间的淋巴结评估情况,包括淋巴结中位数、≥12枚淋巴结的比例以及淋巴结阳性率。然后,获得了5年癌症特异性生存率(CSS)。采用Kaplan-Meier方法和Cox回归模型来评估预后因素与长期生存之间的相关性。尽管PC检查的淋巴结较少,但PC和HC之间的淋巴结阳性率相当,这表明PC下的淋巴结清扫足以反映肿瘤分期。此外,接受PC治疗的患者的5年CSS为67.5%,与接受HC治疗的患者(66.5%)相似。倾向评分匹配后的结果也证实了HC和PC之间生存结果相当。然而,亚组分析表明,肿瘤大小≥5 cm的患者无法从PC中获得生存益处。此外,手术方式并非TCC患者的独立预后因素。因此,尽管PC是一种侵袭性较小的手术方法,但对于选定的TCC患者来说,它应该是一种安全可行的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4dd/5696259/b5773e04441e/oncotarget-08-93236-g001.jpg

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验