教科书式的预后结果有助于老年食管鳞状细胞癌患者的长期预后。
Textbook outcome contributes to long-term prognosis in elderly patients with esophageal squamous cell carcinoma.
作者信息
Matsumoto Chihiro, Iwatsuki Masaaki, Mitsuura Chishou, Morito Atsushi, Maeda Yuto, Toihata Tasuku, Kosumi Keisuke, Baba Yoshifumi, Yoshida Naoya, Baba Hideo
机构信息
Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University Kumamoto Japan.
出版信息
Ann Gastroenterol Surg. 2024 Mar 26;8(5):787-794. doi: 10.1002/ags3.12799. eCollection 2024 Sep.
PURPOSE
Textbook outcome (TO) is a composite quality measurement of outcomes for evaluating surgical procedures. We investigated whether TO can be used to predict outcomes after curative resection for esophageal squamous cell carcinoma (ESCC) in elderly patients.
METHODS
We retrospectively analyzed 105 patients who underwent curative esophagectomy for ESCC from 2005 to 2020. In accordance with previous reports, TO consisted of 10 parameters. The patients were divided into two groups: those who achieved TO (TO) and those who failed to achieve TO (non-TO). We evaluated the association between TO and long-term survival.
RESULTS
TO was achieved in 28 (26%) patients. The patients in the TO group were significantly older ( = 0.02). The parameter with the lowest achievement rate was "No hospital stay ≥21 days". The patients in non-TO group had significantly shorter overall survival than those in TO group ( = 0.03). Multivariable Cox regression analyses of overall survival revealed that lymph node metastasis (hazard ratio [HR], 3.42; 95% confidence interval [CI], 1.73-6.78; < 0.0002) and non-TO (HR, 2.37; 95% CI, 1.05-5.65; = 0.03) were significantly associated with poor overall survival.
CONCLUSION
TO can be used to predict outcomes after curative esophagectomy in elderly patients with ESCC.
目的
教科书式结局（TO）是用于评估外科手术结局的综合质量指标。我们研究了TO是否可用于预测老年食管鳞状细胞癌（ESCC）患者根治性切除术后的结局。
方法
我们回顾性分析了2005年至2020年期间接受ESCC根治性食管切除术的105例患者。根据既往报道，TO由10项参数组成。患者分为两组：达到TO的患者（TO组）和未达到TO的患者（非TO组）。我们评估了TO与长期生存之间的关联。
结果
28例（26%）患者达到TO。TO组患者年龄显著更大（P = 0.02）。达成率最低的参数是“无住院时间≥21天”。非TO组患者的总生存期显著短于TO组患者（P = 0.03）。总生存期的多变量Cox回归分析显示，淋巴结转移（风险比[HR]，3.42；95%置信区间[CI]，1.73 - 6.78；P < 0.0002）和非TO（HR，2.37；95% CI，1.05 - 5.65；P = 0.03）与较差的总生存期显著相关。
结论
TO可用于预测老年ESCC患者根治性食管切除术后的结局。
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