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使用倾向评分匹配分析比较有与无肿瘤急症的可切除结直肠癌术后预后:一项单中心回顾性观察研究。

Comparison of postoperative prognoses for resectable colorectal cancer with vs. without oncologic emergency using propensity score‑matched analyses: A single-center retrospective observational study.

作者信息

Imaizumi Ken, Kasajima Hiroyuki, Sato Kentaro, Ichimura Kentaro, Sato Aya, Yamana Daisuke, Tsuruga Yosuke, Umehara Minoru, Kurushima Michihiro, Nakanishi Kazuaki

机构信息

Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido 041-8680, Japan.

出版信息

Oncol Lett. 2024 Sep 27;28(6):571. doi: 10.3892/ol.2024.14704. eCollection 2024 Dec.

Abstract

While oncological emergencies in colorectal cancer present distinct challenges, existing literature offers conflicting evidence regarding long-term outcomes. Therefore, the present study compared the postoperative prognoses between patients with and without oncological emergencies. A retrospective evaluation was conducted on patients who had undergone radical surgery for pathological stages II and III colorectal cancer at a single center between January 2012 and December 2020. Patients were classified into the non-emergency and oncological emergency groups. The status of oncologic emergency was divided into obstruction and perforation. The outcomes were compared using propensity score matching. The primary objective was to compare the postoperative prognoses between non-emergency and oncological emergency situations. The secondary objectives included comparing prognoses between obstruction and perforation, identifying the type of recurrence depending on the status of oncologic emergency, and assessing the effect of adjuvant chemotherapy for oncologic emergencies. This study included 524 patients. After propensity score matching, the prognoses of oncological emergencies were worse compared with those without any emergency, whereas those of obstruction and perforation did not significantly differ. Regarding the type of recurrence, peritoneal dissemination in obstruction and local recurrence in perforation was more common compared with that in non-emergency cases. Adjuvant chemotherapy improved the recurrence-free survival for cases with oncological emergencies. The prognoses in cases with oncological emergencies could be worse compared with those without any emergency, whereas obstruction and perforation outcomes can be comparable. The administration of adjuvant chemotherapy should be strongly considered for oncological emergencies.

摘要

虽然结直肠癌的肿瘤急症带来了独特的挑战,但现有文献对于长期预后提供了相互矛盾的证据。因此,本研究比较了有和没有肿瘤急症的患者术后的预后情况。对2012年1月至2020年12月期间在单一中心接受病理分期为II期和III期结直肠癌根治性手术的患者进行了回顾性评估。患者被分为非急症组和肿瘤急症组。肿瘤急症的状态分为梗阻和穿孔。使用倾向评分匹配法比较结果。主要目的是比较非急症和肿瘤急症情况下的术后预后。次要目的包括比较梗阻和穿孔之间的预后,根据肿瘤急症状态确定复发类型,以及评估辅助化疗对肿瘤急症的效果。本研究纳入了524例患者。经过倾向评分匹配后,肿瘤急症患者的预后比无任何急症的患者更差,而梗阻和穿孔患者的预后没有显著差异。关于复发类型,与非急症病例相比,梗阻患者的腹膜播散和穿孔患者的局部复发更为常见。辅助化疗改善了肿瘤急症患者的无复发生存率。肿瘤急症患者的预后可能比无任何急症的患者更差,而梗阻和穿孔的结果可能相当。对于肿瘤急症,应强烈考虑给予辅助化疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bc5/11467839/0419666a9587/ol-28-06-14704-g00.jpg

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