Association between surgical approach and survival following resection of abdominopelvic malignancies.
Association between surgical approach and survival following resection of abdominopelvic malignancies.
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DOI：
10.1002/jso.25841
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发表时间：
2020-03
影响因子：
2.5
通讯作者：
Auffenberg GB
中科院分区：
文献类型：
--
作者：
Yuce TK;Ellis RJ;Chung J;Merkow RP;Yang AD;Soper NJ;Tanner EJ;Schaeffer EM;Bilimoria KY;Auffenberg GB
最近的研究表明，宫颈癌微创手术（MIS）后生存率下降，引起了对MIS肿瘤疗效的关注。我们的目的是评估腹盆恶性肿瘤切除术后手术入路与5年生存率之间的关系。从国家癌症数据库中确定了2010-2015年I期或II期前列腺癌、结肠腺癌、直肠腺癌和IA 2期或IB 1期宫颈癌患者。使用倾向评分匹配队列评估手术方法与5年生存率之间的关系。使用logistic回归比较分布。使用考克斯比例风险模型估计死亡风险比。根治性直肠切除术后5年的死亡率为3.4%，结肠切除术后为22.9%，直肠切除术后为18.6%，根治性子宫切除术后为6.8%。开放手术与根治性直肠癌切除术后生存率差相关（HR，1.18; 95% CI，1.05-1.33; P = .005），结肠切除术（HR，1.45; 95% CI，1.39-1.51; P < .001），直肠切除术（HR，1.28; 95% CI，1.10-1.50; P = .002）;然而，开放手术与根治性子宫切除术后生存率的改善相关（HR，0.61; 95% CI，0.44-0.82; P = .003）。这些结果表明，MIS是一种可接受的方法，在选定的患者与前列腺癌，结肠癌和直肠癌，而有关MIS切除宫颈癌的关注似乎是必要的。
Recent studies demonstrating decreased survival following minimally invasive surgery (MIS) for cervical cancer have generated concern regarding oncologic efficacy of MIS. Our objective was to evaluate the association between surgical approach and 5-year survival following resection of abdominopelvic malignancies. Patients with stage I or II adenocarcinoma of the prostate, colon, rectum, and stage IA2 or IB1 cervical cancer from 2010-2015 were identified from the National Cancer Data Base. The association between surgical approach and 5-year survival was assessed using propensity-score-matched cohorts. Distributions were compared using logistic regression. Hazard ratio for death was estimated using Cox proportional-hazard models. The rate of deaths at 5 years was 3.4% following radical prostatectomy, 22.9% following colectomy, 18.6% following proctectomy, and 6.8% following radical hysterectomy. Open surgery was associated with worse survival following radical prostatectomy (HR, 1.18; 95% CI, 1.05-1.33; P = .005), colectomy (HR, 1.45; 95% CI, 1.39-1.51; P < .001), and proctectomy (HR, 1.28; 95% CI, 1.10-1.50; P = .002); however, open surgery was associated with improved survival following radical hysterectomy (HR, 0.61; 95% CI, 0.44-0.82; P = .003). These results suggest that MIS is an acceptable approach in selected patients with prostate, colon, and rectal cancers, while concerns regarding MIS resection of cervical cancer appear warranted.
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影响因子：
3.7
作者：
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