恶病质指数对结直肠癌肝转移肝切除术后结局的显著影响。
Significant impact of cachexia index on the outcomes after hepatic resection for colorectal liver metastases.
作者信息
Tanji Yoshiaki, Furukawa Kenei, Haruki Koichiro, Taniai Tomohiko, Onda Shinji, Tsunematsu Masashi, Shirai Yoshihiro, Yanagaki Mitsuru, Igarashi Yosuke, Ikegami Toru
机构信息
Division of Hepatobiliary and Pancreas Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan.
出版信息
Ann Gastroenterol Surg. 2022 May 11;6(6):804-812. doi: 10.1002/ags3.12578. eCollection 2022 Nov.
INTRODUCTION
The purpose of this study was to investigate the relation between preoperative cachexia index (CXI) and long-term outcomes in patients with colorectal liver metastases (CRLM) after hepatic resection.
METHOD
In all,118 patients who underwent hepatic resection for CRLM were analyzed retrospectively. The relationship between CXI and the long-term outcomes in patients after hepatic resection was investigated. CXI was calculated based on preoperative skeletal muscle index, serum albumin level, and neutrophil-lymphocyte ratio.
RESULTS
The multivariate analysis showed that extrahepatic lesion (hazard ratio [HR] 2.86, 95% confidence interval [CI] 1.48-5.53, < .01) and high CXI (HR 0.44, 95% CI 0.20-0.98, = .04) were independent and significant predictors of disease-free survival. Moreover, extrahepatic lesion (HR 2.32, 95% CI 1.03-5.22, = .04), high CXI (HR 0.17, 95% CI 0.05-0.57, < .01), and curability R 1 or 2 (HR 3.29, 95% CI 1.23-8.78, = .02) were independent and significant predictors of overall survival.
CONCLUSION
CXI is a useful prognostic factor for disease-free survival and overall survival after hepatic resection in CRLM patients.
引言
本研究旨在探讨术前恶病质指数（CXI）与结直肠癌肝转移（CRLM）患者肝切除术后长期预后之间的关系。
方法
对118例行CRLM肝切除术的患者进行回顾性分析。研究CXI与肝切除术后患者长期预后的关系。CXI根据术前骨骼肌指数、血清白蛋白水平和中性粒细胞与淋巴细胞比值计算得出。
结果
多因素分析显示，肝外病变（风险比[HR]2.86，95%置信区间[CI]1.48 - 5.53，P <.01）和高CXI（HR 0.44，95% CI 0.20 - 0.98，P = 0.04）是无病生存的独立且显著预测因素。此外，肝外病变（HR 2.32，95% CI 1.03 - 5.22，P = 0.04）、高CXI（HR 0.17，95% CI 0.05 - 0.57，P <.01）以及根治性R 1或2（HR 3.29，95% CI 1.23 - 8.78，P = 0.02）是总生存的独立且显著预测因素。
结论
CXI是CRLM患者肝切除术后无病生存和总生存的有用预后因素。
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