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年轻与老年结直肠癌患者行原发性手术的短期和肿瘤学结局:倾向评分匹配分析。

The short-term and oncologic outcomes of younger VS older colorectal cancer patients undergoing primary surgery: a propensity score matching analysis.

机构信息

Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing, Medical University, Chongqing, 400016, China.

Department of Clinical Nutrition, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

出版信息

BMC Cancer. 2022 Feb 8;22(1):153. doi: 10.1186/s12885-022-09246-4.

Abstract

PURPOSE

The purpose of the current study is to analyze the difference of short-term and oncologic outcomes between younger and older colorectal cancer (CRC) patients who underwent primary CRC surgery using a propensity score matching (PSM) analysis.

METHODS

We retrospectively collected CRC patients who underwent primary surgery in a single clinical database from Jan 2011 to Jan 2020. The short-term and oncologic outcomes were compared between younger aged group and older aged group.

RESULTS

A total of 4599 patients were included in this study, and there were 4196 patients in older aged group and 403 patients in younger aged group. After 1:1 ratio PSM, there were 401 patients in each group. No significant difference was found in terms of baseline information after PSM (p>0.05). Younger aged group had larger retrieved lymph nodes before (p<0.001) and after PSM (p=0.001) than older aged group. In multivariate analysis, younger age was an independent predictor of better overall survival (OS) (p<0.001, HR=2.303, 95% CI=1.658-3.199) and disease-free survival (DFS) (p=0.008, HR=1.425, 95% CI=1.098-1.850). In terms of different tumor stage after PSM, younger aged group had better OS than older group in stage II (p<0.001) and stage IV (p=0.028) CRC, and younger aged group had better DFS than older group in stage II (p=0.016) CRC.

CONCLUSION

Younger CRC patients had larger retrieved lymph nodes and better prognosis than older CRC patients after primary CRC surgery.

摘要

目的

本研究旨在通过倾向评分匹配(PSM)分析,分析接受原发性结直肠癌(CRC)手术的年轻和老年 CRC 患者短期和肿瘤学结局的差异。

方法

我们回顾性收集了 2011 年 1 月至 2020 年 1 月期间在单个临床数据库中接受原发性手术的 CRC 患者。比较了年轻组和老年组之间的短期和肿瘤学结局。

结果

共纳入 4599 例患者,其中老年组 4196 例,年轻组 403 例。经 1:1 比例 PSM 后,每组各有 401 例。PSM 后两组基线资料无统计学差异(p>0.05)。年轻组术前(p<0.001)和 PSM 后(p=0.001)检索的淋巴结数量明显大于老年组。多因素分析显示,年龄较轻是总生存(OS)(p<0.001,HR=2.303,95%CI=1.658-3.199)和无病生存(DFS)(p=0.008,HR=1.425,95%CI=1.098-1.850)的独立预测因素。PSM 后不同肿瘤分期,年轻组 II 期(p<0.001)和 IV 期(p=0.028)CRC 的 OS 优于老年组,年轻组 II 期(p=0.016)CRC 的 DFS 优于老年组。

结论

与老年 CRC 患者相比,接受原发性 CRC 手术后,年轻 CRC 患者检索的淋巴结更多,预后更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48fa/8822831/39d66052dbfd/12885_2022_9246_Fig1_HTML.jpg

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