POSSUM predicts decreased overall survival in curative resection for colorectal cancer
POSSUM predicts decreased overall survival in curative resection for colorectal cancer
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DOI：
10.1007/s10350-005-0284-5
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发表时间：
2006-06-01
影响因子：
3.9
通讯作者：
Engel, Alexander F.
中科院分区：
文献类型：
--
作者：
Brosens, Rebecca P.;Oomen, Joannes L.;Engel, Alexander F.
目得：由生理POSSUM评分确定的手术条件差与结直肠癌手术的术后死亡率和发病率相关。本研究旨在分析结直肠癌患者手术时病情与长期总生存率的关系。方法：共有542名I、II或III期结直肠癌根治性切除术患者幸存。计算所有患者手术时的生理POSSUM评分（不包括年龄）。平均生理POSSUM评分作为临界点，以确定低风险和高风险组患者。采用考克斯比例风险分析研究低危组和高危组对总生存期的影响，并确定独立的危险因素。研究结果：低危组患者的5年总生存率显著高于高危组患者（低危组66.6% vs高危组48.5%; P < 0.001）。当分别分析I期、II期和III期患者时，也发现了总生存期的差异。总生存率的危险因素是疾病晚期、肿瘤分化差、粘液腺癌、年龄大于70岁和手术时患者状况差。结论：由生理POSSUM评分确定的手术时不良状况是结直肠癌患者长期总生存的风险指标。
PURPOSE: Poor condition at operation determined by the physiologic POSSUM score is related to postoperative mortality and morbidity of colorectal cancer surgery. This study was designed to analyze the relationship between condition of patients with colorectal cancer at operation and long-term overall survival. METHODS: A total of 542 patients survived a radical resection for Stages I, II, or III colorectal cancer. Physiologic POSSUM score at surgery, exclusive of age, was calculated for all patients. Mean physiologic POSSUM score was used as cutoff point to determine low-risk and high-risk group patients. A Cox proportional hazard analysis was performed to study the effect of low-risk and high-risk group on overall survival and to identify independent risk factors. RESULTS: Five-year overall survival was significantly higher in low-risk group patients than in high-risk group patients (low-risk group 66.6 percent vs. high-risk group 48.5 percent; P < 0.001). Differences in overall survival also were found when patients in Stages I, II, and III were analyzed separately. Risk factors for overall survival were advanced stage of disease, poor tumor differentiation, mucinous adenocarcinoma, older than age 70 years, and poor condition of the patient at time of operation. CONCLUSIONS: Poor condition at operation, as determined by physiologic POSSUM score, is a risk indicator for long-term overall survival in colorectal cancer patients.