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在根治性切除术前,格拉斯哥预后评分可能预测胃癌患者的术后并发症。

The Glasgow Prognostic Score Before Curative Resection May Predict Postoperative Complications in Patients with Gastric Cancer.

机构信息

Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Japan.

Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, Japan.

出版信息

J Gastrointest Cancer. 2022 Dec;53(4):908-914. doi: 10.1007/s12029-021-00689-9. Epub 2021 Sep 14.

Abstract

PURPOSE

Despite improvements in surgical techniques and devices and perioperative care of gastric cancer (GC), the rate of postoperative complications still has not decreased. If patients at high risk for postoperative complications could be identified early using biomarkers, these complications might be reduced. In this study, we investigated usefulness of the preoperative Glasgow Prognostic Score (GPS) as a predictive factor for complications after surgery in patients with stage II/III GC.

METHODS

This study retrospectively analyzed the outcomes of 424 patients who underwent curative surgery for pathological stage II/III GC from February 2007 to July 2019 at a single center. The GPS was assessed within 4 days before surgery. To identify independent risk factors for postoperative complications, univariate and multivariate analyses were performed using a Cox proportional hazards model.

RESULTS

The numbers of patients with a GPS of 0, 1, and 2 were 357, 55, and 12, respectively. The rate of complications after surgery was significantly higher among patients with a GPS of 1 or 2 than among patients with a GPS of 0 (p = 0.008). Multivariate analysis identified a GPS of 1 or 2 as an independent predictive factor for postoperative complications (p = 0.037).

CONCLUSION

The preoperative GPS may be a useful predictive factor for postoperative complications in patients with stage II/III GC. Being aware of the risk of complications after surgery as indicated by the GPS before surgery may promote safe and minimally invasive surgery that we expect will improve outcomes in patients with a GPS of 1 or 2.

摘要

目的

尽管胃癌(GC)的手术技术和设备以及围手术期护理有所改进,但术后并发症的发生率仍未降低。如果能够使用生物标志物早期识别术后并发症风险较高的患者,这些并发症可能会减少。在这项研究中,我们研究了术前格拉斯哥预后评分(GPS)作为预测 II/III 期 GC 患者手术后并发症的指标的有用性。

方法

本研究回顾性分析了 2007 年 2 月至 2019 年 7 月在单中心接受根治性手术治疗病理 II/III 期 GC 的 424 例患者的结果。GPS 在手术前 4 天内进行评估。为了确定术后并发症的独立危险因素,使用 Cox 比例风险模型进行单因素和多因素分析。

结果

GPS 为 0、1 和 2 的患者人数分别为 357、55 和 12。GPS 为 1 或 2 的患者术后并发症发生率明显高于 GPS 为 0 的患者(p=0.008)。多因素分析确定 GPS 为 1 或 2 是术后并发症的独立预测因子(p=0.037)。

结论

术前 GPS 可能是预测 II/III 期 GC 患者术后并发症的有用指标。在手术前根据 GPS 了解术后并发症的风险可能会促进安全微创的手术,我们期望这将改善 GPS 为 1 或 2 的患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f1e/9630216/d540c516fd5c/12029_2021_689_Fig1_HTML.jpg

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