Benefit of operative mortality reduction on colorectal cancer survival
Benefit of operative mortality reduction on colorectal cancer survival
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DOI：
10.1046/j.1365-2168.2002.02276.x
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发表时间：
2002-12-01
影响因子：
9.6
通讯作者：
Faivre, J
中科院分区：
文献类型：
--
作者：
Mitry, E;Bouvier, AM;Faivre, J
背景：这项研究的目的是确定在一个明确定义的人群中20年来结直肠癌手术后死亡率的趋势，以及对总体生存的影响。方法：1976年至1995年在一个拥有50万人口的法国地区登记了约4745例新的结直肠腺癌病例。结果：1976-1979年至1992-1995年间，手术死亡率由17.7%降至8.1%。根治性手术后的相应率分别为12.6%和6.2%。诊断年限、年龄和部位是影响手术死亡率的独立因素。将1976-1979年期间的手术死亡率应用到1992-1995年的队列中，预计根治性手术后的5年存活率为40.0%，而观察到的存活率为51.0%。这相当于5年总存活率提高了27.5%。将这一结果应用于整个法国人口，据估计，由于手术死亡率的下降，法国每年可避免近3000例死亡。结论：在研究的20年中，手术死亡率显著下降。这与手术治愈后存活率的显著提高有关。
Background: The aim of this study was to determine trends in operative mortality after colorectal cancer surgery over a 20-year period in a well defined population, and consequences on overall survival.Methods: Some 4745 new cases of colorectal adenocarcinoma were registered between 1976 and 1995 in a French region containing 500 000 people. Among these, 84.3 per cent were operated on, of whom 78.1 per cent were resected.Results: The overall operative mortality rate decreased from 17.7 to 8.1 per cent between 1976-1979 and 1992-1995. Corresponding rates after curative surgery were 12.6 and 6.2 per cent respectively. Period of diagnosis, age and subsite were factors independently associated with operative mortality. Applying the operative mortality rates for the interval 1976-1979 to the 1992-1995 cohort, the expected 5-year survival rate after curative surgery would have been 40.0 per cent, compared with an observed rate of 51.0 per cent. This corresponds to a 27.5 per cent improvement in 5-year overall survival. Applying this result to the French population as a whole, it was estimated that almost 3000 deaths are avoided each year in France as a result of the reduction in operative mortality.Conclusion: Operative mortality decreased dramatically over the 20 years of the study. It was associated with a significant improvement in survival after surgery for cure.