Department of Surgery, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomatsuri, Utsunomiya, Tochigi, 320-8580, Japan.
Health Information Manager, National Hospital Organization Tochigi Medical Center, Utsunomiya, Tochigi, Japan.
J Gastrointest Cancer. 2023 Dec;54(4):1261-1267. doi: 10.1007/s12029-023-00924-5. Epub 2023 Feb 21.
We hypothesized that preoperative tooth loss could predict general health conditions, including inflammation, postoperative complications (POCs), and overall survival (OS), in patients with colorectal cancer (CRC) and other gastrointestinal cancers.
Data of patients who underwent curative surgical resection for CRC during 2017-2021 at our hospital were retrieved. The primary outcomes were POCs, whereas the secondary endpoint was OS. According to the Japanese database, patients within each age range with more than the age-adjusted average number of teeth were classified as the Oral N (normal) group, whereas those with less than the age-adjusted average number of teeth were classified as the Oral A (abnormal) group. The relationship between tooth loss and POCs was assessed using a logistic regression model.
Overall, 146 patients were enrolled, with 68 (46.6%) and 78 (53.4%) patients in the Oral N and A groups, respectively. In the multivariate analysis, the Oral A group was an independent risk factor for POCs [hazard ratio (HR), 5.89; 95% confidence interval (CI), 1.81-19.1; p < 0.01]. Similarly, univariate analysis revealed that the Oral A group tended to be associated with OS (HR, 4.57; 95% CI, 0.99-21.2; p = 0.052), but the association was not statistically significant.
In CRC patients who underwent curative resection, tooth loss was a predictor of POCs. Although further investigations are needed, our results support the use of tooth loss as a simple and essential preoperative evaluation system.
我们假设术前牙齿缺失可预测包括炎症、术后并发症(POC)和总生存(OS)在内的一般健康状况,这些状况在结直肠癌(CRC)和其他胃肠道癌症患者中。
本研究检索了 2017 年至 2021 年期间在我院接受根治性手术切除的 CRC 患者的数据。主要终点是 POC,次要终点是 OS。根据日本数据库,每个年龄范围内的患者中,牙齿数量超过年龄调整平均值的被归类为口腔 N(正常)组,而牙齿数量少于年龄调整平均值的被归类为口腔 A(异常)组。使用逻辑回归模型评估牙齿缺失与 POC 之间的关系。
共有 146 名患者入组,口腔 N 组和口腔 A 组分别为 68 例(46.6%)和 78 例(53.4%)。多变量分析显示,口腔 A 组是 POC 的独立危险因素[风险比(HR),5.89;95%置信区间(CI),1.81-19.1;p<0.01]。同样,单变量分析显示,口腔 A 组倾向于与 OS 相关(HR,4.57;95%CI,0.99-21.2;p=0.052),但无统计学意义。
在接受根治性切除术的 CRC 患者中,牙齿缺失是 POC 的预测因素。尽管需要进一步研究,但我们的结果支持将牙齿缺失作为一种简单而基本的术前评估系统的使用。