摘要
背景:结肠直肠癌肝转移最好的处理仍在争论,我们对治疗幸存者的真正影像知之甚少。 材料和方法:该研究涉及122个患者(77男),年龄 64.0 ± 11.0(范围: 27.8–86.1),诊断为肝转移(少于59人同步)。全部经过化疗和至少一次射频消融,53人做了肝部分切除。我们用单变量和多变量技术分析了肝转移人口统计资料,肿瘤性质和存活结果。该分析把相关生存率考虑为特特异生存率的最佳估计。 结果:这个利用观察生存率的分析把结肠直肠样本中涉及的淋巴结的分类数选为唯一有统计学意义的预测因素,而利用相关存活率的分析显示原发肿瘤的位置(在乙状结肠直肠上面或相反)和肝转移的数量是重要因素。标准化死亡率是9.673(95% CI: 7.668–11.663),与参照人群相比一共损失了201.85年生命。 结论:相关生存率的计算-好于观察生存率-选择更充足的预测因素,使对带有混杂因素的有限种类病人的断测变得可靠。预后主要依赖原发肿瘤和肝转移解剖情况而不是治疗的发现可以解释在该领域可用的治疗方法的立场上对比鲜明的意见。
关键词: 结肠直肠癌,肝转移,多变量分析,预测因素,相关生存率,特异生存率
图形摘要
Current Cancer Drug Targets
Title:The Prognosis of Patients with Liver Metastases from Colorectal Cancer still Depends on Anatomical Presentation more than on Treatments
Volume: 15 Issue: 6
Author(s): Paolo G. Gobbi, Sandro Rossi, Mario Comelli, Valentina Ravetta, Laura L. Rosa and Silvia Brugnatelli, Franco Corbella, Sara Delfanti, Islam Abumalouh and Paolo Dionigi
Affiliation:
关键词: 结肠直肠癌,肝转移,多变量分析,预测因素,相关生存率,特异生存率
摘要: Background: The best management of liver metastases from colorectal cancer is still debated and little is known about the true impact of treatments on survival.
Materials and Methods: The study involved 122 patients (77 males), aged 64.0 ± 11.0 years (range: 27.8–86.1) at diagnosis of liver metastatization (synchronous in 59). All underwent chemotherapy and at least one procedure of radiofrequency ablation; 53 also had partial hepatic resections. Demographics, tumor characteristics and survival outcomes from liver metastatization were analyzed with univariate and multivariate techniques. This analysis was performed also taking into account relative survival as the best estimate of specific survival.
Results: The analysis with observed survival selected the categorized number of involved lymph nodes in the colorectal specimens as the only statistically significant predictor, while the analysis with relative survival also showed site of the primary tumor (above the sigmoid colon or otherwise) and number of liver metastases as significant factors. The standardized mortality ratio was 9.673 (95% CI: 7.668–11.663) and a total of 201.85 years of life were lost in comparison with the survival of the reference population.
Conclusions: The computation of relative survival – better than observed survival – selected a more adequate number of predictors, making investigation of even limited series of patients with confounding factors reliable. The finding that prognosis was mainly dependent on the anatomical presentation of the primary tumor and of liver metastases – instead of treatments – could explain the still contrasting opinions on the role of the available therapies in this field.
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Paolo G. Gobbi, Sandro Rossi, Mario Comelli, Valentina Ravetta, Laura L. Rosa and Silvia Brugnatelli, Franco Corbella, Sara Delfanti, Islam Abumalouh and Paolo Dionigi , The Prognosis of Patients with Liver Metastases from Colorectal Cancer still Depends on Anatomical Presentation more than on Treatments, Current Cancer Drug Targets 2015; 15 (6) . https://dx.doi.org/10.2174/1568009615666150508094824
DOI https://dx.doi.org/10.2174/1568009615666150508094824 |
Print ISSN 1568-0096 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5576 |
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