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影响II期和III期结直肠癌患者生存的预后因素

Prognostic Factors Influencing Survival in Stage II and Stage III Colorectal Cancer Patients.

作者信息

Alkader Mohammad S, Al-Majthoub Murad Z, Al-Qerem Walid A, Alkhader Doa'a M, Alhusban Aseel M, Abdulkareem Muna A, Abweny Bashar, Hamawi Alaa T, Muslem Hala F, Omeish Rasha A, Al-Adwan AlAnoud M, Al Halaiqah Hamed A

机构信息

Department of Medical Oncology, Jordanian Royal Medical Services, Amman, JOR.

Department of Internal Medicine, Jordanian Royal Medical Services, Amman, JOR.

出版信息

Cureus. 2023 Oct 6;15(10):e46575. doi: 10.7759/cureus.46575. eCollection 2023 Oct.

Abstract

Background Colorectal cancer (CRC) is a global health concern with rising incidence. This study analyzed demographic and clinicopathological factors influencing overall survival (OS) and disease-free survival (DFS) in Jordanian CRC patients. Methodology This retrospective, single-center study collected data from CRC patients at the Royal Medical Services, Jordan, from January 2018 to June 2020. Patient variables included disease stage, stage risk, tumor location, history of chemotherapy, and metastasis status. OS and DFS were defined as the time from surgery to death, last follow-up, or metastasis confirmation. Kaplan-Meier curves and Cox models were used for survival analysis. Results Of 127 CRC patients, 33.3% died during the follow-up period. Most patients were males (55.1%), diagnosed with stage III (55.9%), and classified as high risk (59.2%). Metastasis occurred in 24.4%, and 65.4% received chemotherapy. OS at one, two, and end of the follow-up years was 85.2%, 75.6%, and 66.9%, respectively. Metastasis-free rates were 85%, 78.5%, and 71%, respectively. Multivariate analysis showed that stage III (hazard ratio (HR) = 2.968) and high-risk stage (HR = 2.966) were associated with shorter OS and increased metastasis risk. Right-sided tumors (HR = 2.183) had shorter OS, while chemotherapy recipients (HR = 0.430) had longer OS. Stage III and high-risk stages were strong predictors of mortality, while only stage III and high-risk stages were robust predictors of metastasis. Demographic variables (sex and age) showed no significant associations with survival outcomes. Conclusions Our findings highlight the prognostic significance of disease stage, stage risk, tumor location, and chemotherapy in CRC survival among Jordanian patients. Understanding these factors can guide tailored treatment and improve outcomes.

摘要

背景

结直肠癌(CRC)是一个全球关注的健康问题,其发病率呈上升趋势。本研究分析了影响约旦CRC患者总生存期(OS)和无病生存期(DFS)的人口统计学和临床病理因素。

方法

这项回顾性单中心研究收集了2018年1月至2020年6月期间约旦皇家医疗服务机构CRC患者的数据。患者变量包括疾病分期、分期风险、肿瘤位置、化疗史和转移状态。OS和DFS定义为从手术到死亡、最后一次随访或转移确认的时间。采用Kaplan-Meier曲线和Cox模型进行生存分析。

结果

127例CRC患者中,33.3%在随访期间死亡。大多数患者为男性(55.1%),诊断为III期(55.9%),并被归类为高危(59.2%)。24.4%发生转移,65.4%接受了化疗。随访1年、2年和随访结束时的OS分别为85.2%、75.6%和66.9%。无转移率分别为85%、78.5%和71%。多变量分析显示,III期(风险比(HR)=2.968)和高危期(HR = 2.966)与较短的OS和转移风险增加相关。右侧肿瘤(HR = 2.183)的OS较短,而接受化疗的患者(HR = 0.430)的OS较长。III期和高危期是死亡率的强预测因素,而只有III期和高危期是转移的可靠预测因素。人口统计学变量(性别和年龄)与生存结果无显著关联。

结论

我们的研究结果突出了疾病分期、分期风险、肿瘤位置和化疗在约旦CRC患者生存中的预后意义。了解这些因素可以指导个体化治疗并改善治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f38/10625675/a56a5a13926e/cureus-0015-00000046575-i01.jpg

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