The relationship between patient physiology, the systemic inflammatory response and survival in patients undergoing curative resection of colorectal cancer.
The relationship between patient physiology, the systemic inflammatory response and survival in patients undergoing curative resection of colorectal cancer.
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DOI：
10.1038/sj.bjc.6605919
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发表时间：
2010-10-26
影响因子：
8.8
通讯作者：
中科院分区：
文献类型：
--
作者：
越来越多的人认识到，宿主相关因素在决定癌症结局方面可能很重要。目的是研究患者生理学、全身炎症反应和结直肠癌切除术后生存率之间的关系。从前瞻性维护的数据库中确定接受潜在治愈性结直肠癌切除术的患者。使用死亡率和发病率计数（POSSUM）标准的生理和手术严重度评分评估患者生理学。采用改良的格拉斯哥预后评分（mGPS）评估全身炎症反应。多因素5年生存分析，计算风险比（HR）。共纳入320例患者。在随访期间（中位数74个月），有136例死亡：83例与结直肠癌相关，53例与非癌症相关。癌症特异性生存率的独立预测因素为年龄（HR：1.46，P<0.01）、Dukes分期（HR：2.39，P<0.001）、mGPS（HR：1.78，P<0.001）和POSSUM生理评分（HR：1.38，P=0.02）。总生存率的预测因素为年龄（HR：1.64，P<0.001）、吸烟（HR：1.52，P=0.02）、Dukes分期（HR：1.64，P<0.001）、mGPS（HR：1.60，P<0.001）和POSSUM生理评分（HR：1.27，P=0.03）。mGPS与POSSUM生理评分之间也存在相关性（P<0.006）。POSSUM生理学评分和全身炎症反应密切相关，两者都是接受潜在治愈性结直肠癌切除术患者的癌症特异性和总生存率的独立预测因子。
It is increasingly recognised that host-related factors may be important in determining cancer outcome. The aim was to examine the relationship between patient physiology, the systemic inflammatory response and survival after colorectal cancer resection. Patients undergoing potentially curative resection of colorectal cancer were identified from a prospectively maintained database. Patient physiology was assessed using the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) criteria. The systemic inflammatory response was assessed using the modified Glasgow Prognostic Score (mGPS). Multivariate 5-year survival analysis was carried out with calculation of hazard ratios (HR). A total of 320 patients were included. During follow-up (median 74 months), there were 136 deaths: 83 colorectal cancer related and 53 non-cancer related. Independent predictors of cancer-specific survival were age (HR: 1.46, P<0.01), Dukes stage (HR: 2.39, P<0.001), mGPS (HR: 1.78, P<0.001) and POSSUM physiology score (HR: 1.38, P=0.02). Predictors of overall survival were age (HR: 1.64, P<0.001), smoking (HR: 1.52, P=0.02), Dukes stage (HR: 1.64, P<0.001), mGPS (HR: 1.60, P<0.001) and POSSUM physiology score (HR: 1.27, P=0.03). A relationship between mGPS and POSSUM physiology score was also established (P<0.006). The POSSUM physiology score and the systemic inflammatory response are strongly associated and both are independent predictors of cancer specific and overall survival in patients undergoing potentially curative resection of colorectal cancer.
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影响因子：
9
作者：
Ishizuka, Mitsuru;Nagata, Hitoshi;Kubota, Keiichi
通讯作者：
Kubota, Keiichi
影响因子：
2.3
作者：
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影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
Witteman, Jacqueline C. M.
影响因子：
8.8
作者：
McArdle, C S;Hole, D J
通讯作者：
Hole, D J