Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Dis Colon Rectum. 2018 Nov;61(11):1273-1280. doi: 10.1097/DCR.0000000000001196.
Recent studies have suggested that electrolyte disorders might be a negative prognostic factor for some diseases.
The purpose of this study was to systematically evaluate the prognostic role of electrolyte disorders in patients with stage I to III colorectal cancer who received radical surgical resection.
This study was retrospectively performed.
The study was conducted at a single tertiary care center.
Patients with colorectal cancer who underwent radical resection in between April 2007 and April 2014 were included.
The Kaplan-Meier method was adopted to estimate the overall and disease-free survival with and without propensity score matching.
In total, our study recruited 5089 eligible patients. In prematching analysis, patients with hypochloremia showed both shorter overall survival (HR = 0.943 (95% CI, 0.908-0.980); p = 0.003) and disease-free survival (HR = 0.957 (95% CI, 0.933-0.981); p < 0.001) than those with normal serum chloride levels. In postmatching analysis, 770 patients from each group were compared, and the results further confirmed that hypochloremia was significantly associated with worse overall survival (HR = 0.646 (95% CI, 0.489-0.855); p = 0.002) and disease-free survival (HR = 0.782 (95% CI, 0.647-0.944); p = 0.01), with the hypochloremia group as a reference.
The study was limited by its retrospective nature.
Hypochloremia diagnosed before treatment can independently prognosticate the overall and disease-free survival for patients with stage I to Ш colorectal cancer after radical resection. Intensive surveillance and management might improve the survival outcome for patients with hypochloremia. See Video Abstract at http://links.lww.com/DCR/A727.
最近的研究表明，电解质紊乱可能是某些疾病的预后不良因素。
本研究旨在系统评估电解质紊乱对接受根治性手术切除的 I 期至 III 期结直肠癌患者的预后作用。
本研究为回顾性研究。
本研究在一家三级保健中心进行。
纳入 2007 年 4 月至 2014 年 4 月期间接受根治性切除术的结直肠癌患者。
采用 Kaplan-Meier 法估计有无倾向评分匹配时的总生存率和无病生存率。
本研究共纳入 5089 例符合条件的患者。在预匹配分析中，低氯血症患者的总生存率（HR = 0.943（95%CI，0.908-0.980）；p = 0.003）和无病生存率（HR = 0.957（95%CI，0.933-0.981）；p < 0.001）均短于血清氯水平正常的患者。在匹配后分析中，比较了每组 770 例患者，结果进一步证实低氯血症与总生存率（HR = 0.646（95%CI，0.489-0.855）；p = 0.002）和无病生存率（HR = 0.782（95%CI，0.647-0.944）；p = 0.01）显著相关，以低氯血症组为参照。
本研究受其回顾性性质的限制。
治疗前诊断的低氯血症可独立预测根治性切除术后 I 期至 III 期结直肠癌患者的总生存率和无病生存率。强化监测和管理可能改善低氯血症患者的生存结局。详见全文 http://links.lww.com/DCR/A727。
