术前椎体骨折：I-III 期结直肠癌的预后因素。

Preoperative Vertebral Fracture: A Prognostic Factor in Stage I-III Colorectal Cancer.

机构信息

Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan;

Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Anticancer Res. 2024 Aug;44(8):3533-3541. doi: 10.21873/anticanres.17174.

DOI:10.21873/anticanres.17174

PMID:39060080

Abstract

BACKGROUND/AIM: This study evaluated the prognostic impact of vertebral fractures (VFs) on the survival of patients with colorectal cancer (CRC).

PATIENTS AND METHODS

We included 299 patients with stage I-III CRC who had undergone elective surgery. The patients were divided into the VF group (n=94) and non-VF group (n=205). VFs were assessed using sagittal computed tomography image reconstruction (Th11-L5) performed preoperatively. Disease-free survival (DFS) and overall survival (OS) rates were analyzed.

RESULTS

The VF group had lower 5-year DFS and OS rates compared to the non-VF group (both, p<0.001). The independent predictors of DFS were carbohydrate antigen 19-9 (CA19-9) ≥37.0 ng/ml, T3/T4 disease, stage III CRC, osteopenia, and VF; for OS, CA19-9 ≥37.0 ng/ml, stage III, osteopenia, and VF. VF, compared with osteopenia, was a more significant prognostic factor for DFS and OS in patients with stage I+ II CRC (both, p<0.001).

CONCLUSION

Preoperative VF was associated with worse DFS and OS following CRC resection.

摘要

背景/目的：本研究评估了脊柱骨折（VF）对结直肠癌（CRC）患者生存的预后影响。

患者和方法

我们纳入了 299 例接受择期手术的 I-III 期 CRC 患者。患者被分为 VF 组（n=94）和非 VF 组（n=205）。术前通过矢状位计算机断层扫描图像重建（Th11-L5）评估 VF。分析无病生存率（DFS）和总生存率（OS）。

结果

VF 组的 5 年 DFS 和 OS 率均低于非 VF 组（均，p<0.001）。DFS 的独立预测因素为碳水化合物抗原 19-9（CA19-9）≥37.0ng/ml、T3/T4 疾病、III 期 CRC、骨质疏松症和 VF；OS 的独立预测因素为 CA19-9≥37.0ng/ml、III 期、骨质疏松症和 VF。与骨质疏松症相比，VF 是 I+II 期 CRC 患者 DFS 和 OS 的更重要的预后因素（均，p<0.001）。