Poskus Eligijus, Kryzauskas Marius, Poskus Tomas, Mikalauskas Saulius, Samalavicius Narimantas Evaldas, Aliosin Oleg, Dailidenas Sarunas, Tamelis Algimantas, Saladzinskas Zilvinas, Lizdenis Paulius, Jakaitiene Audrone, Smailyte Giedre, Strupas Kestutis
Institute of Clinical Medicine, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Vilnius, Lithuania.
Department of Surgery, Klaipeda University Hospital, 41 Liepojos Str, LT-92288, Klaipeda, Lithuania.
Int J Colorectal Dis. 2018 Jun;33(6):779-785. doi: 10.1007/s00384-018-3021-y. Epub 2018 Mar 12.
To compare perioperative colorectal cancer care and survival in patient cohorts operated in 2005 and in 2010 in Lithuania.
Comparative observational cohort study was performed. The study was conducted in the three Lithuanian cancer hospitals. Patients, who underwent curative surgery for colorectal cancer in 2005 and 2010, were included. Demographic characteristics, distribution of the tumors, preoperative diagnostics and staging, surgical treatment, the quality of pathological examination, morbidity, and mortality were analyzed. One- and 5-year overall survival data were compared between the groups.
Colorectal cancer diagnostics and treatment improved from 2005 to 2010 significantly. The disease was identified as stage III-IV for 45 vs. 48% of the patients; however, computed tomography staging scan was performed only for 5.9 vs. 17.8% in 2005 and 2010, respectively. Laparoscopic operations were performed 1.5 vs. 10.5% and abdominoperineal resections-42.7 vs. 31.7% in 2005 and 2010, respectively. The number of harvested lymph nodes was mentioned in 55.8 vs. 97.7% of the cases, whereas more than 12 lymph nodes were examined in 18 vs. 66.6% of cases after histological examination. The overall 5-year survival was 52.1 vs. 63.1% (p < 0.0001), while the 5-year survival of the patients with stage IV of disease was 4.2 vs. 17.8% in 2005 and 2010, respectively.
Preoperative investigation, surgical treatment, pathological examination, and postoperative course are associated with improved overall survival in colorectal cancer patients, undergoing curative surgery in the resource-limited settings.
比较2005年和2010年在立陶宛接受手术的患者队列中围手术期结直肠癌护理情况及生存率。
进行了一项比较性观察队列研究。该研究在立陶宛的三家癌症医院开展。纳入2005年和2010年接受结直肠癌根治性手术的患者。分析了人口统计学特征、肿瘤分布、术前诊断与分期、手术治疗、病理检查质量、发病率和死亡率。比较了两组的1年和5年总生存数据。
从2005年到2010年，结直肠癌的诊断和治疗有显著改善。疾病被确定为III-IV期的患者比例分别为45%和48%；然而，2005年和2010年分别仅对5.9%和17.8%的患者进行了计算机断层扫描分期扫描。2005年和2010年腹腔镜手术的实施率分别为1.5%和10.5%，腹会阴联合切除术的实施率分别为42.7%和31.7%。55.8%和97.7%的病例提及了采集的淋巴结数量，而组织学检查后，18%和66.6%的病例检查了超过12个淋巴结。总体5年生存率分别为52.1%和63.1%（p<0.0001），2005年和2010年疾病IV期患者的5年生存率分别为4.2%和17.8%。
在资源有限地区接受根治性手术的结直肠癌患者中，术前检查、手术治疗、病理检查和术后病程与总体生存率的提高相关。
