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结直肠癌围手术期应用ω-3 脂肪酸补充剂的长期疗效。

Long-term outcomes after perioperative treatment with omega-3 fatty acid supplements in colorectal cancer.

机构信息

Department of Gastrointestinal Surgery, Aalborg, Denmark.

Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark.

出版信息

BJS Open. 2020 Aug;4(4):678-684. doi: 10.1002/bjs5.50295. Epub 2020 May 11.

Abstract

BACKGROUND

This study aimed to evaluate the effect of perioperative supplementation with omega-3 fatty acids (n-3 FA) on perioperative outcomes and survival in patients undergoing colorectal cancer surgery.

METHODS

Patients scheduled for elective resection of colorectal cancer between 2007 and 2010 were randomized to either an n-3 FA-enriched oral nutrition supplement (ONS) twice daily or a standard ONS (control) for 7 days before and after surgery. Outcome measures, including postoperative complications, 3-year cumulative incidence of local or metastatic colorectal cancer recurrence and 5-year overall survival, were compared between the groups.

RESULTS

Of 148 patients enrolled in the study, 125 (65 patients receiving n-3 FA-enriched ONS and 60 receiving standard ONS) were analysed. There were no differences in postoperative complications after surgery (P = 0·544). The risk of disease recurrence at 3 years was similar (relative risk 1·66, 95 per cent c.i. 0·65 to 4·26).The 5-year survival rate of patients treated with n-3 FA was 69·2 (95 per cent c.i. 56·5 to 78·9) per cent, compared with 81·7 (69·3 to 89·4) per cent in the control group (P = 0·193). After adjustment for age, stage of disease and adjuvant chemotherapy, n-3 FA was associated with higher mortality compared with controls (hazard ratio 1·73, 95 per cent c.i. 1·06 to 2·83; P = 0·029). The interaction between n-3 FA and adjuvant chemotherapy was not statistically significant.

CONCLUSION

Perioperative supplementation with n-3 FA did not confer a survival benefit in patients undergoing colorectal cancer surgery. n-3 FA did not benefit the subgroup of patients treated with adjuvant chemotherapy or decrease the risk of disease recurrence.

摘要

背景

本研究旨在评估围手术期补充ω-3 脂肪酸(n-3 FA)对接受结直肠癌手术患者围手术期结局和生存的影响。

方法

2007 年至 2010 年间,择期接受结直肠癌切除术的患者被随机分为每日两次接受富含 n-3 FA 的口服营养补充剂(ONS)或标准 ONS(对照组)的两组,在手术前后各持续 7 天。比较两组患者的术后并发症、3 年局部或转移性结直肠癌复发的累积发生率和 5 年总生存率等结局指标。

结果

在纳入研究的 148 例患者中,125 例(65 例接受富含 n-3 FA 的 ONS,60 例接受标准 ONS)进行了分析。两组术后并发症无差异(P=0.544)。3 年时疾病复发风险相似(相对风险 1.66,95%可信区间 0.65 至 4.26)。接受 n-3 FA 治疗的患者 5 年生存率为 69.2%(95%可信区间 56.5%至 78.9%),对照组为 81.7%(69.3%至 89.4%)(P=0.193)。在校正年龄、疾病分期和辅助化疗后,n-3 FA 与对照组相比,死亡率更高(风险比 1.73,95%可信区间 1.06 至 2.83;P=0.029)。n-3 FA 与辅助化疗之间的交互作用无统计学意义。

结论

围手术期补充 n-3 FA 不能使接受结直肠癌手术的患者获益。n-3 FA 不能使接受辅助化疗的患者亚组获益,也不能降低疾病复发的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f657/7397352/933cbbd5eca8/BJS5-4-678-g001.jpg

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