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结肠癌的部位对流行病学、临床表现、手术、病理及肿瘤学结局的影响

Impact of Sidedness of Colon Cancer on Epidemiological, Clinical Presentation, Surgical, Pathological, and Oncologic Outcomes.

作者信息

Moraes Filho Oswaldo de, Alves Martins Bruno Augusto, Silva André Araujo de Medeiros, Nóbrega Dos Santos Antonio Carlos, de Almeida Romulo Medeiros, Sousa João Batista

机构信息

Coloproctology Service, University Hospital of Brasília, University of Brasilia, Brasília 70840-901, DF, Brazil.

School of Medicine, University of Brasília, Brasília 70840-901, DF, Brazil.

出版信息

J Pers Med. 2024 Dec 16;14(12):1153. doi: 10.3390/jpm14121153.

Abstract

The purpose of the study was to identify potential differences between patients with right colon cancer and left colon cancer in epidemiological, clinical presentation, pathological, and surgical results in addition to the impact of the sidedness on disease-free survival (DFS) and overall survival (OS). Patients with a diagnosis of colon cancer stages I-IV between 2010 and 2020 were identified from a prospective database in a tertiary single center. Right and left-sided cancer were compared regarding epidemiological, clinical presentation, pathological, and surgical results. Survival analysis was conducted using the Kaplan-Meier method and adjusted hazard ratios for mortality (OS) and disease-free survival (DFS) were obtained using Cox proportional hazards regression. The right colon group included 82 (31%) patients and the left colon group 182 (69%). After adjusted analysis, RCC presented less bleeding (RP: 0.31; CI: 0.18-0.56; : 0.0001) and change in bowel habits (RP: 0.60; CI: 0.41-0.87; : 0.0069). A laparotomy approach was more performed in LCC (RP: 0.64; CI: 0.47-0.86; : 0.0029). Regarding pathological results, RCC had more poorly differentiated tumors (RP: 0.81; CI: 0.70-0.94; : 0.05). In the adjusted analysis, there was no difference in survival for right-sided compared to left-sided colon cancer: the hazard ratios were 1.36 (CI 95%: 0.61-3.01; : 0.4490) for OS and 2.04 (CI: 0.91-4.59; : 0.0814) for DFS. In this population-based cohort, we found no impact of colon cancer sidedness on OS and DFS. RCC presented less differentiated tumors and LCC presented more bleeding and change in bowel habits.

摘要

本研究的目的是确定右半结肠癌和左半结肠癌患者在流行病学、临床表现、病理及手术结果方面的潜在差异,以及肿瘤部位对无病生存期(DFS)和总生存期(OS)的影响。从一家三级单中心的前瞻性数据库中识别出2010年至2020年间诊断为I-IV期结肠癌的患者。比较右半结肠癌和左半结肠癌在流行病学、临床表现、病理及手术结果方面的差异。采用Kaplan-Meier法进行生存分析,并使用Cox比例风险回归获得死亡率(OS)和无病生存期(DFS)的调整风险比。右半结肠组包括82例(31%)患者,左半结肠组包括182例(69%)患者。经过调整分析,右半结肠癌患者出血较少(风险比:0.31;置信区间:0.18-0.56;P:0.0001),排便习惯改变较少(风险比:0.60;置信区间:0.41-0.87;P:0.0069)。左半结肠癌患者更常采用剖腹手术方式(风险比:0.64;置信区间:0.47-0.86;P:0.0029)。在病理结果方面,右半结肠癌的低分化肿瘤更多(风险比:0.81;置信区间:0.70-0.94;P:0.05)。在调整分析中,右半结肠癌与左半结肠癌的生存率无差异:总生存期的风险比为1.36(95%置信区间:0.61-3.0

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84c7/11677301/6ddc9728ad5f/jpm-14-01153-g001.jpg

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